Study Shows Need for Improved Hospital Selection for Minorities

Minority patients in New York were less likely than whites to have surgeries at hospitals with a large number of procedures, according to a study published in the Archives of Surgery.

The study focused on 134,000 people who had 20 different types of surgery between 2001 and 2004 in hospitals in New York City, as well as nearby Nassau and Westchester counties. The study involved mostly whites, and fewer numbers of blacks, Asians, and Hispanics.

Compared with white patients, "treatment at high-volume hospitals by high-volume surgeons was lower by 11.8 % for black patients; 8% for Asian patients, and 7% for Hispanic patients," wrote Andrew J. Epstein of Yale's School of Public Health, the lead author of the study, "Racial and Ethnic Differences in the Use of High-Volume Hospitals and Surgeons."

In effect, the minority patients were "doubly-disadvantaged," the authors noted.

The researchers concluded that quality care improvements are needed for minority patients to assist them in choosing hospitals and physicians because studies have shown the effectiveness of high-volume hospitals.

"In addition to efforts to improve the quality of care among providers serving minority patients, policymakers and clinicians may be able to improve outcomes by encouraging minority patients and their surrogates to consider comparative performance information when choosing hospitals and surgeons," the researchers stated.

The study focused on 10 procedures and used state hospital discharge data. The procedures involved cancer treatment, coronary, and other conditions.

"Better information is needed about which providers minority patients have access to and how they select them," the study said.