A new study finds disparities in the Utilization of High-Volume Hospitals for Complex Surgery. This is not surprising at all given the fact that complex surgeries cost more and hospitals and doctors do what ever they can to divert the “self-pays” or lower paying patients to other facilities, defer these procedures or make it more difficult for these patients to have this sort of surgeries done.
The study findings were as follows:
A total of 719 608 patients received 1 of the 10 operations. Overall, nonwhites, Medicaid patients, and uninsured patients were less likely to receive care at high-volume hospitals and more likely to receive care at low-volume hospitals when controlling for other patient-level characteristics. Blacks were significantly (P<.05) less likely than whites to receive care at high-volume hospitals for 6 of the 10 operations (relative risk [RR] range, 0.40-0.72), while Asians and Hispanics were significantly less likely to receive care at high-volume hospitals for 5 (RR range, 0.60-0.91) and 9 (RR range, 0.46-0.88), respectively. Medicaid patients were significantly less likely than Medicare patients to receive care at high-volume hospitals for 7 of the operations (RR range, 0.22-0.66), while uninsured patients were less likely to be treated at high-volume hospitals for 9 (RR range, 0.20-0.81).
The authors conclude that:
There are substantial disparities in the characteristics of patients receiving care at high-volume hospitals. The interest in selective referral to high-volume hospitals should include explicit efforts to identify the patient and system factors required to reduce current inequities regarding their use.
You can view the article at the JAMA site.
Posted on October 25, 2006 by Site Staff
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