Mortality rates as a proxy measure for hospital quality are significant predictors of whether or not hospitals will demonstrate racial disparities in care, according to research published in the Journal of the American Medical Association.
Using 2007-2008 data from the national Medicare database, researchers examined the relationship between surgical outcomes — mortality rates after coronary artery bypass graft surgery — and race for nearly 174,000 patients, controlling for socioeconomic status and other patient characteristics.
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Overall, nonwhite patients had 33 percent higher mortality rates after CABG surgery than white patients. For hospitals treating the highest proportions of nonwhite patients, mortality differed by one percentage point, with white mortality at 3.8 percent and nonwhite mortality a percentage point higher.
While hospital quality adjusted for socioeconomic status of patients explained more than half of the difference in mortality rates between racial groupings, it left some of the difference unaccounted for; nonwhite patients still had 16 percent higher mortality rates after CABG surgery.
Researchers suggested efforts to reduce racial disparities in treatment should focus on hospitals with a high proportion of nonwhite patients.
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