Report finds Black patients more likely to be admitted into hospitals with worse safety conditions

A report from the Urban Institute finds Black patients are significantly more likely than white patients to be admitted into hospitals with worse patient safety conditions. This discrepancy, reasons the report, may be a driver of overall disparities in outcomes.

The report evaluated racial disparities in 11 different patient safety quality measures. Four indicators measured general patient safety, and the other 7 specifically examined the risk of adverse events related to surgical procedures.


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In an evaluation of discharge records across 26 states during 2017, the report found Black patients experienced significantly worse quality of care compared to white patients on 6 of the 11 safety measures. This includes 5 of the 7 surgery-related patient safety indicators.

White and Black patients encountered similar quality of care for 3 of the 11 indicators and white patients saw worse care on 2 of the measures.

The report also found that for 9 of the 11 patient safety measures, Black patients were less likely to be admitted into “high quality” hospitals, which the report describes as those hospitals that are best at minimizing patient safety risk. This discrepancy between rates of admission was significant. The report states:

“The differences in admissions into quality hospitals was large, with white patients being more than 9 percentage points more likely to be admitted into high quality hospitals on four indicators and more than 7 percentage points more likely to be admitted into high-quality hospitals on six indicators.”

To address these disparities and reduce the differences in quality, the report says its important to either widen the racial mix of patients seen in high quality hospitals, or allocate resources to improve patient safety conditions at hospitals serving communities of color.

While this report examined the quality of hospitals used by Black versus white patients, the author says future analysis will examine differences in quality of care received within hospitals which could be caused by discrimination or biases.