Study Examines Quality of Care at Hospitals Treating Disproportionate Number of Black Patients

"Concentration and Quality of Hospitals That Care for Elderly Black Patients," Archives of Internal Medicine: The study examined whether the characteristics of hospitals disproportionately caring for blacks contribute to quality of care. For the study, researchers Ashish Jha and Arnold Epstein of Harvard School of Public Health's Department of Health Policy and Management and colleagues used 2004 Medicare hospital quality data to determine how many elderly black and white patients were treated at the hospitals studied. They then examined each hospital's structural characteristics and performance for treatment of acute myocardial infarction, congestive heart failure and pneumonia according to Hospital Quality Alliance measures. Researchers found that 5% of U.S. hospitals cared for nearly 45% of all black patients and that 25% of hospitals cared for about 90% of elderly black patients. Hospitals with the highest number of black patients primarily were teaching hospitals located in southern states. Hospitals that treated a high number of black patients had worse performance scores for acute myocardial infarction and pneumonia. However, researchers concluded that hospitals treating a large number of black patients "have only marginally worse quality of care than those that care for a low proportion of black patients." They also noted that the "level of concentration of black patients provides a fresh opportunity to improve care for black patients by targeting efforts toward a small group of hospitals" (Jha et al., Archives of Internal Medicine, 6/11).