Study Examines Quality of Care for Minority Patients at U.S. Hospitals

"Disparities in Health Care Are Driven by Where Minority Patients Seek Care: Examination of the Hospital Quality Alliance Measures," Archives of Internal Medicine: For the report, Romana Hasnain-Wynia of the Health Research and Educational Trust, Joel Weissman of Harvard Medical School and Anne Beal, senior program officer of the Commonwealth Fund, examined quality-of-care data reported by U.S. hospitals participating in the Hospital Quality Alliance, which measures and reports on quality-of-care data. Data was collected on 320,970 adult patients from 123 teaching hospitals across the nation. Forty percent of the patients were minorities. Based on 13 quality measures for treatment of acute myocardial infarction, congestive heart failure, community-acquired pneumonia and patient counseling, researchers found small, statistically significant disparities in all but one of the quality measures. After ranking the hospitals based on performance, researchers also found that minorities were more likely to receive care from the lower-performing hospitals. The most significant disparity was found in counseling services, such as smoking cessation services. Researchers suggested that "communication training may improve the rates of the counseling measures for minority patients." They suggested more research to determine the effect that low performing hospitals have on disparities in care but added, "Policy recommendations may need to focus on pay-for-improvement metrics for those under-resourced providers caring for the most disadvantaged populations" (Commonwealth Fund release, 6/25).