Racial disparity found in hospitals

Black patients are significantly more likely to suffer dangerous bleeding, infections and other serious problems related to surgical procedures than are white patients treated in the same hospital, according to a new analysis from the nonprofit Urban Institute.

The analysis, funded by the Robert Wood Johnson Foundation, builds on earlier research showing that Black patients are more likely than white ones to endure injuries and acquire illnesses in the hospital.

A previous analysis from the Urban Institute found that part of the reason for that gap is that Black patients are less likely to be admitted to "high-quality" hospitals than white patients, based on key measures meant to gauge patient care.

But the new report found that even when they are going to the same hospitals, Black patients are more likely to suffer illnesses or injuries tied to surgical procedures, including hemorrhages during the surgical process and sepsis following an operation, than white patients of the same gender and age group.

"Even when admitted to the same hospital, Black patients experience higher rates of hospital-acquired injuries or illnesses occurring during or shortly after surgical procedures relative to white patients," the analysis concluded.

That troubling pattern persisted even when researchers compared Black and white patients with similar kinds of insurance coverage, when they focused specifically on patients covered by Medicare, and when they limited their analysis to hospitals with a higher percentage of Black patients, which could theoretically be more adept at rooting out racial bias.

And the analysis found that it didn't make much difference whether the hospitals had more or fewer resources, as gauged by their share of patients with private insurance.

Closing racial gaps in patient care will require changing the way that health care is provided within each hospital, not just changing who goes to which hospital, the report concluded.

"You're going to have to do some work within institutions," Gangopadhyaya said.

The Urban Institute analysis examined hospital discharge records from roughly half of states across the country — not including California — as of four years ago. The information, drawn from Agency for Healthcare Research and Quality databases, included complete records for discharges from more than 2,300 hospitals.

The analysis looked at nearly a dozen measures of patient safety, including "general patient safety indicators" tied to a broad range of hospital discharges, such as how frequently patients got infections related to catheters, or pressure ulcers from remaining in one position too long, as well as injuries and illnesses specifically related to surgical procedures.

Such measures are used by health care researchers as a way to zero in on problems associated with faulty care in hospitals, rather than the ailments that patients have when they walk in the door.

The report found that the evidence was mixed on whether Black patients had worse results for the "general patient safety indicators" than white patients in the same hospital.

Gangopadhyaya said it's "hard to think about where to start" in addressing the issue.