Navigation Links
Minorities, uninsured less likely to receive care at high-volume hospitals

Compared to white patients, black, Asian and Hispanic patients and those who are uninsured are less likely to undergo complex surgery at high-volume hospitals, which have been associated with better outcomes, according to a study in the October 25 issue of JAMA.

Efforts to improve the quality of surgical care in the United States have led many organizations to advocate the use of high-volume hospitals for certain procedures, since a number of studies have reported of a direct volume-outcome relationship for certain procedures, with patients at high-volume hospitals consistently having better outcomes. It appears there are important differences in the racial and socioeconomic status of patients who receive care at high- and low-volume hospitals, according to background information in the article. These differences may affect the ability to access or receive care at a high-volume hospital.

Jerome H. Liu, M.D., M.S.H.S., of the David Geffen School of Medicine at the University of California-Los Angeles, and colleagues conducted a study to determine whether the use of high-volume hospitals varies by race/ethnicity or insurance status in a broad population of patients undergoing complex surgical care. The researchers examined patient characteristics and use of high-volume hospitals across 10 hospital-based procedures with known volume-outcome relationships among Californians during a 5-year period (2000-2004), collecting data from California's Office of Statewide Health Planning and Development patient discharge database.

The procedures included elective abdominal aortic aneurysm repair, coronary artery bypass grafting, carotid endarterectomy, esophageal cancer resection, hip fracture repair, lung cancer resection, cardiac valve replacement, coronary angioplasty, pancreatic cancer resection, and total knee replacement.

According to this database, a total of 719,608 patients received 1 of the 10 operations. The researchers found that " 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.


'"/>

Source:JAMA and Archives Journals


Related biology news :

1. Low oxygen likely made Great Dying worse, greatly delayed recovery
2. FDA: Highly Unlikely Green Tea Lowers Cancer Risk
3. Next good dinosaur news likely to come from small packages
4. Medical experts: US unlikely to have enough vaccines to stop avian flu
5. Parts of the Caribbean and Central America are likely to have less summer rain
6. Access to antiretrovirals unlikely to reduce HIV infection rates
7. Coffee makes us more likely to say yes
8. Farm kids almost twice as likely to die from injury as children overall
9. Ozone recovering, but unlikely to stabilize at pre-1980 levels, says study
10. Tamed 11,400 years ago, figs were likely first domesticated crop
11. Older fathers more likely to have autistic children
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:4/6/2017)... LONDON , April 6, 2017 ... Control, RFID, ANPR, Document Readers, by End-Use (Transportation & ... Energy Facility, Oil, Gas & Fossil Generation Facility, Nuclear ... Healthcare, Educational, Other) Are you looking for ... Authentication sector? ...
(Date:4/5/2017)... , April 5, 2017 Today HYPR ... that the server component of the HYPR platform is ... providing the end-to-end security architecture that empowers biometric authentication ... HYPR has already secured over 15 million users across ... manufacturers of connected home product suites and physical access ...
(Date:4/4/2017)... NEW YORK , April 4, 2017   ... solutions, today announced that the United States Patent and ... The patent broadly covers the linking of an iris ... the same transaction) and represents the company,s 45 th ... our latest patent is very timely given the multi-modal ...
Breaking Biology News(10 mins):
(Date:4/26/2017)... Pa. , April 26, 2017  Genisphere ... delivery platform, has signed a collaborative and sponsored ... Dr. Silvia Muro . The overall goal ... and pharmacodynamics of various 3DNA designs and formulations ... involve targeting diseases of the vasculature as well ...
(Date:4/25/2017)... CA (PRWEB) , ... April 25, 2017 , ... ... of L3 Healthcare, is pleased to announce the company is now a certified ... The iMedNet software certification enables the company’s clinical research team to build, ...
(Date:4/25/2017)... Gatos, California (PRWEB) , ... April 25, 2017 ... ... business, Analytical Services and Metrology Partners.     , Covalent’s Analytical Services unit ... Most samples can be measured within 24 hours of receipt. There are no ...
(Date:4/24/2017)... 2017  Dante Labs announced today the offer of whole ... $900). While American individuals have been able to access WGS ... access WGS below EUR 1,000. The sequencing includes ... information to make informed decisions about disease monitoring, prevention, nutrition, ... ...
Breaking Biology Technology: