Hospitals may be doing a better job of reducing health care disparities among racial and ethnic minorities than previously believed.
Between 2005 and 2010, disparities in care between white patients and black patients fell for 13 of the 17 Centers for Medicare & Medicaid Services inpatient process measures. Disparities between white and Hispanic patients fell for 14 of the measures, according to a report published in the New England Journal of Medicine in the Dec. 11, 2014, issue.
The results followed what were disappointing findings last spring by the Institute for Diversity in Health Management that showed stagnation in minority representation on both hospital management and boards.
“It is definitely a really encouraging study with quite robust results,” says Akin Demehin, senior associate director of policy for the American Hospital Association.
Big reductions were found for measures with previously wide disparities. Using PCI [percutaneous coronary intervention] within 90 minutes after arrival at the hospital — one of the heart attack measures — compliance among white patients rose to 91.7 percent from 43.4 percent; among black patients it climbed to 86.3 percent from 29.2 percent; and for Hispanic patients it climbed to 89.7 percent from 34.1 percent. Big improvement could also be found for pneumonia care and vaccination rates against influenza.
“That’s a sign that engaging in quality improvement efforts really has the effect of providing better care for everybody, for all patients,” Demehin says.
But don’t get too excited. The results are not conclusive evidence that actual care is improving, says Marilyn Lynk, director of operations for Adventist HealthCare’s Center for Health Equity and Wellness. Outcomes measures would offer a better representation, and history indicates that improvement is still needed in reducing disparities found in outcomes data, Lynk says. There have been general findings that minorities are less than satisfied regarding communication with providers. It will vary widely by hospital, she says.
Lynk suggests that hospitals study their own data for signs of disparities in their care, a job that should be getting easier with the use of electronic health records.
Moreover, community health needs assessments, required of hospitals under the Affordable Care Act, can help to identify disparities and inspire action that is tailored for the community’s needs, both inside and outside hospital walls, Lynk says.