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Measuring hospital-specific disparities by dual eligibility and race to reduce health inequities.

Authors :
Lloren, Anouk
Liu, Shuling
Herrin, Jeph
Lin, Zhenqiu
Zhou, Guohai
Wang, Yongfei
Kuang, Meng
Zhou, Sheng
Farietta, Thalia
McCole, Kerry
Charania, Sana
Dorsey Sheares, Karen
Bernheim, Susannah
Source :
Health Services Research. Feb2019 Supplement S1, Vol. 54, p243-254. 12p. 5 Charts, 3 Graphs.
Publication Year :
2019

Abstract

<bold>Objective: </bold>To propose and evaluate a metric for quantifying hospital-specific disparities in health outcomes that can be used by patients and hospitals.<bold>Data Sources/study Setting: </bold>Inpatient admissions for Medicare patients with acute myocardial infarction, heart failure, or pneumonia to all non-federal, short-term, acute care hospitals during 2012-2015.<bold>Study Design: </bold>Building on the current Centers for Medicare and Medicaid Services methodology for calculating risk-standardized readmission rates, we developed models that include a hospital-specific random coefficient for either patient dual eligibility status or African American race. These coefficients quantify the difference in risk-standardized outcomes by dual eligibility and race at a given hospital after accounting for the hospital's patient case mix and proportion of dual eligible or African American patients. We demonstrate this approach and report variation and performance in hospital-specific disparities.<bold>Principal Findings: </bold>Dual eligibility and African American race were associated with higher readmission rates within hospitals for all three conditions. However, this disparity effect varied substantially across hospitals.<bold>Conclusion: </bold>Our models isolate a hospital-specific disparity effect and demonstrate variation in quality of care for different groups of patients across conditions and hospitals. Illuminating within-hospital disparities can incentivize hospitals to reduce inequities in health care quality. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00179124
Volume :
54
Database :
Academic Search Index
Journal :
Health Services Research
Publication Type :
Academic Journal
Accession number :
134233429
Full Text :
https://doi.org/10.1111/1475-6773.13108