Re-Exploring Racial Disparities in Hospital Care

Governors State University, University Park IL

Investigators

Linked publications & trials

Abstract

DESCRIPTION: Eliminating racial disparities in health care is a national priority. Although many studies have examined racial differences in aspects of hospital care such as severity of illness, care-seeking patterns, use of clinical procedures, use of resources, and outcome, no published research has integrated and examined these aspects simultaneously. Moreover, while many studies have reported racial disparities in hospital care only a few of them have examined the interactive effects between race and other factors on hospital care. Finally, while most of race-related studies on hospital care have focused on comparisons between one minority and non-Hispanic Caucasians, very few studies have examined health outcomes among the three largest racial groups (non-Hispanic Caucasians, African-Americans, and Hispanic-Americans) simultaneously, let alone other ethnic groups. The proposed study forms an integrated conceptual framework, based on the concept of episode of care, the behavioral framework of health care use, and the structure-process-outcome triad, to examine the relationships between race and hospital care, in a systemic and comprehensive manner. The episode of hospital care, from the patient?s perspective, can be described by five dimensions: severity of illness, care-seeking patterns, process or receiving treatment, economic outcome, and clinical outcome. The study, with the inclusion of patients from all ethnic groups, focuses on four major diseases (heart attack, congestive heart failure, pneumonia, and stroke), extracts data from the 1995, 1997, 1999 National Inpatient Sample (NIS) datasets collected by the Hospital Cost and Utilization Project (HCUP), adopts validated administrative data based, risk adjustment methods, conducts multivariate analysis to control for potential confounding factors. This allows systemic exploration of the relationships between race and the five episode of hospital care -dimensions and, in particular, to examines the interactive effects between race and other factors on outcome that are measured by the in-hospital mortality risk. Findings from this research will furnish information to help public and private sectors decision-makers better understand the racial gaps in hospital care in a more systemic way. It will also elucidate key factors that result in gaps in service to vulnerable populations. This will aid public policy development of effective interventions to improve health care delivery-with regard to eliminating racial disparities.