The difference between a "best" and "worst" designation can be the difference between life and death for someone with heart disease or pneumonia, the study authors said. For example, heart-attack patients were found to face a 7 percent to 10 percent higher risk for dying at one of the worst hospitals, compared to similar patients at the best.
The authors observed that the best hospitals were more often in the Northeast, and were more likely to be non-profit facilities outfitted with more state-of- the-art equipment for such problems as cardiac illness.
The worst institutions were more likely to be for-profit or public facilities, and were more likely to be located in the South.
In addition to the doubling of black patient populations in the worst institutions, the study authors also noted that while Hispanics accounted for just 1 percent of the patient pool in the best hospitals, they made up 4 percent in the worst. Similarly, while Medicaid patients accounted for just 15 percent of all patients in the best facilities, they constituted 23 percent among the worst.
"Now I want to stress that there is nothing inherent about caring for poor or minority patients that should make it so that it is inevitable that they be subject to lower-quality care," said Jha. "But the truth is that we see it over and over again."
Dr. Ali Salim, an attending surgeon and program director of the General Surgery Residency Educational Program at Cedars-Sinai Medical Center in Los Angeles, expressed little surprise with the study findings.
"First off, it should be said that these points made in this study are all just associations," he cautioned. "There is no cause and effect that can be gleaned by their observation.
"But this is definitely an important and
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