Disparities in healthcare result from where minority and nonminority patients receive services, according to a new article published in the June 25 issue of the Archives of Internal Medicine. In a study supported by the Commonwealth Fund, researchers examined the quality of care received by some 321,000 patients age 18 and olderof whom 40% were minoritiesat 123 teaching hospitals nationwide participating in the Hospital Quality Alliance. The alliance is a public-private collaboration formed to measure and publicly report on the quality of hospital care. According to the findings, minority patients receive lower-quality care, and lower-performing hospitals tend to serve a larger proportion of minority patients. The most significant disparities were for counseling services, such as discharge instructions or smoking-cessation counseling, which require time, patient interaction and documentation, according to the article. Also, the study divided the hospitals into the best performers and worst performers for 13 measures. After adjusting for the site of care, the magnitudes of disparities decreased substantially. Policy recommendations may need to focus on pay-for-improvement metrics for those under-resourced providers caring for the most disadvantaged populations, the authors wrote, adding that programs and policies to eliminate disparities should be informed by research that identifies the underlying causes of lower performance in hospitals. -- by Jessica Zigmond
Commonwealth Fund reportsstate of minority care
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