Racial and ethnic disparities in the use of high-volume hospitals.
Differences in the source of care could contribute to racial and ethnic disparities in health status. This study looks at a major metropolitan area and examines racial and ethnic differences in the use of high-volume hospitals for 17 services for which there is a documented positive volume-outcome relationship. Focusing on the hospitalizations of New York City area residents in the periods 1995-1996 and 2001-2002, we found, after controlling for socioeconomic characteristics, insurance coverage, proximity of residence to a high-volume hospital, and paths to hospitalization, that minority patients were significantly less likely than whites to be treated at high-volume hospitals for most volume-sensitive services. The largest disparities were between blacks and whites for cancer surgeries and cardiovascular procedures.
Gray
Bradford H
BH
Urban Institute, 2100 M St., N.W., Washington DC 20037, USA. bgray@urban.org
Schlesinger
Mark
M
Siegfried
Shannon Mitchell
SM
Horowitz
Emily
E
D000368:Aged; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*