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Disparities in Health Care Are Driven by Where Minority Patients Seek Care |
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From The Commonwealth Fund: Many studies have documented that minority patients receive lower-quality health care than non-minority patients at the same medical facilities. Relatively few, however, have attempted to explain the source of racial and ethnic disparities in care. Do they result from a lack of cultural understanding on the part of health care providers? According to a study supported by The Commonwealth Fund, disparities are largely the result of differences in where minority and non-minority patients seek health care. In "Disparities in Health Care Are Driven by Where Minority Patients Seek Care" (Archives of Internal Medicine, June 25, 2007), a research team including Romana Hasnain-Wynia, Ph.D., of the Health Research and Educational Trust, Joel Weissman, Ph.D., of Harvard Medical School, and Fund senior program officer Anne Beal, M.D., M.P.H., examined quality-of-care data reported by U.S. hospitals participating in the Hospital Quality Alliance, a public/private collaboration formed to measure and publicly report on the quality of hospital care. The researchers found minority patients receive lower quality care, especially counseling services, and that lower-performing hospitals tend to serve a larger proportion of minority patients. The Hospital Quality Alliance measures included recommended treatments (e.g., providing aspirin, beta blockers, or antibiotic therapy) for three clinical conditions: acute myocardial infarction, congestive heart failure, and community-acquired pneumonia, as well as patient counseling. Previous research suggests communication training benefits can be enhanced by considering patients' race, ethnicity, and culture. "Policy recommendations may need to focus on pay-for-improvement metrics for those under-resourced providers caring for the most disadvantaged populations," the authors write, concluding that programs and polices to reduce and potentially eliminate disparities should be informed by research that identifies and targets the underlying causes of lower performance in hospitals.
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