To understand the drivers of racial separation of care and their impact on hospital admissions among Black and minority populations.
Approach:
Study Design: Cross-sectional analysis using data from the Medicare Current Beneficiary Survey (MCBS) linked to Medicare claims.
Hypotheses Tested: 1) Neighborhood deprivation and health care market residential segregation are associated with hospitalization in Black-serving hospitals (BSH) independent of other factors. 2) These associations differ by race, with a larger effect for Black patients. 3) Asso…
Data Collection: Data collected from January 2011 through December 2020, focusing on respondents aged 65 and older with at least one hospitalization.
Hospital Classification: Hospitals were classified as BSH or minority-serving hospitals (MSH) based on the racial composition of their patient population.
Key Findings:
Racial disparities in health outcomes persist despite de jure desegregation of hospitals.
Half of hospitalizations among Black Medicare beneficiaries occurred in only 12% of hospitals.
Black-serving hospitals (BSH) have lower revenue, profit, and access to specialty care.
Residential racial segregation is associated with racial separation of hospital care.
Interpretation:
Racial separation of care contributes to health disparities, with Black patients often receiving care in lower-quality hospitals.
Limitations:
The study focused on Medicare beneficiaries, which may not represent the entire population.
Data limited to hospitalizations may not capture all factors influencing care decisions.
Conclusion:
Understanding the factors influencing hospital admissions can help identify intervention points to address racial disparities in health outcomes.
