Report: Black Patients More Likely to Receive Low-Quality Care Than White Patients

March 31st, 2021

By Jill Drachenberg, Editor, Relias Media

Disparities between Black and white patients in rates of adverse patient safety events persist, with Black patients more likely to experience these adverse outcomes. Moreover, Black patients were more likely to be admitted to lower-quality hospitals than white patients, according to an analysis from the Urban Institute.

Researchers used 2017 hospital discharge data from hospitals in 26 states. “The primary focus of this study is to assess whether Black and white patients are systematically admitted into hospitals with different overall patient safety conditions,” the authors noted. Overall, Black patients were 7.9% more likely than white patients to be admitted to hospitals considered low-quality across seven surgical patient safety measures, and 4.9% less likely than white patients to be admitted to high-performing hospitals. The seven measures are:

• postoperative kidney injury requiring dialysis (31% of Black patients admitted to high-quality hospitals vs. 37.7% of white patients);
• postoperative respiratory failure (31% of Black patients vs. 42.5% of white patients);
• perioperative hematoma or hemorrhage (17.7% of Black patients vs. 23.7% of white patients);
• perioperative deep vein thrombosis or pulmonary embolism (17.4% of Black patients vs. 30.1% of white patients);
• postoperative sepsis rate (21.3 of Black patients vs. 30.9% of white patients);
• postoperative wound dehiscence rate (46.8% of Black patients vs. 50.3% of white patients);
• abdominopelvic accidental puncture or laceration (27.4% of Black patients vs. 33% of white patients).

“This evidence suggests that relative to white patients, Black patients are simultaneously less likely to access hospitals that are best in minimizing adverse surgery-related patient safety events across all or most criteria and more likely to be admitted into hospitals classified as low quality across several surgery-related patient safety measures,” the authors indicated.

Differences in age, gender, and Medicare coverage do not account for these disparities, the authors noted. Improving access to high-quality hospitals and policy changes to improve hospital quality outcomes are needed to improve these disparities.

“Disparities in patient safety by race are unacceptable symptoms of unequal health care in America. Moreover, these differences are addressable, as this analysis shows that many hospitals have been successful in eliminating adverse events across many measures of patient safety,” the authors concluded. “Thus, factors that expand patient access to high-quality hospitals could contribute to reducing patient safety disparities.”