hat "in general, blacks, Asians, Hispanics, patients with Medicaid, and uninsured patients were less likely to go to high-volume hospitals for complex surgical procedures but more likely to go to low-volume hospitals, when compared with whites and patients with Medicare. Furthermore, patients with private insurance were significantly more likely to go to high-volume hospitals for 3 of the surgical procedures."

For all 10 operations, black patients were significantly less likely to receive care at high-volume hospitals in 6 of the operations, Asians less likely in 5, and Hispanics less likely in 9.

Medicaid patients were significantly less likely than Medicare patients to receive care at high-volume hospitals for 7 of the operations, while uninsured patients were less likely to be treated at high-volume hospitals for 9.

" our study demonstrates robust findings in a large (12 percent of the U.S. population), ethnically diverse population that includes all patients undergoing the selected procedures without restrictions based on demographics, insurance, or sampling. While there is significant interest among health care policy experts in improving quality by directing patients to high-volume hospitals, policy development should include explicit efforts to identify the patient and system factors required to reduce current inequities in the receipt of care at such hospitals," the authors conclude.

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Contact: Rachel Champeau
310-794-0777
JAMA and Archives Journals
24-Oct-2006

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