Mortality After Acute Myocardial Infarction in Hospitals That Disproportionately Treat Black Patients

Skinner, Jonathan; Chandra, Amitabh; Staiger, Douglas O.; Lee, Julie; McClellan, Mark

doi:10.1161/circulationaha.105.543231

Cited by 224 publications

(199 citation statements)

References 60 publications

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“…It is known that variations between health facilities contribute to treatment disparities in other countries, 18,[34][35][36][37][38][39] particularly the United States, where ethnic segregation of healthcare is marked 36,40 and is likely to be a major cause of treatment differences between black and white patients. 35,37,41,42 We made some attempt to assess the influence of facility differences on Maori/non-Maori treatment disparities by adjusting for the type of hospital where patients underwent surgery (treating this as the patient's primary treatment facility). However, our crude categorization (public cancer center hospitals, public hospitals without cancer centers, and private hospitals) failed to capture the considerable variation that exists within these groups and may not have captured relevant facility type in cases where patients underwent surgical and oncology treatment in different facilities.…”

Section: Discussionmentioning

confidence: 99%

“…43 Evidence from the United States suggests that interpersonal discrimination contributes to ethnic disparities in care, 7,9 but treatment inequities there are driven more by differences between healthcare providers than by differential care within the same facility. 35,37,42 The balance of these factors may be somewhat different in New Zealand, where ethnic segregation is less marked than in the United States.…”

Section: Discussionmentioning

confidence: 99%

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Ethnicity and management of colon cancer in New Zealand

Hill

Sarfati

Blakely

et al. 2010

Cancer

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BACKGROUND: Racial and ethnic inequalities in colon cancer treatment have been reported in the United States but not elsewhere. The authors of this report compared cancer treatment in a nationally representative cohort of Maori (indigenous) and non-Maori New Zealanders with colon cancer. METHODS: On the basis of cancer registry data, 301 Maori patients and 329 randomly selected non-Maori patients were identified who were diagnosed with colon cancer between 1996 and 2003. Medical notes were reviewed, and surgical and oncology treatments were compared by indigenous status. RESULTS: Maori and non-Maori patients had similar rates of surgical resection, although Maori patients were less likely to undergo extensive lymph node clearance and were more likely to die during the postoperative period. Maori patients were significantly less likely to receive chemotherapy for stage III disease (relative risk [RR], 0.69; 95% confidence interval [CI], 0.53-0.91) and were more likely to experience a delay of at least 8 weeks before starting chemotherapy (RR, 1.98; 95%CI, 1.23-3.16). Treatment disparities were not explained by differences in tumor characteristics or patient comorbidity. CONCLUSIONS: Maori New Zealanders with colon cancer were less likely to receive adjuvant chemotherapy and experienced a lower quality of care compared with non-Maori patients. The authors concluded that attention to health system factors is needed to ensure equal access and quality of cancer treatment for indigenous and ethnic minority populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ethnicity and management of colon cancer in New Zealand

Hill

Sarfati

Blakely

et al. 2010

Cancer

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“…Two studies suggest that the concentration of black patients in a relatively small number of hospitals contribute to disparities in quality care (Skinner et al 2005;Jha et al 2007). Black-serving hospitals compared to other hospitals were found to have higher rates for some patient safety indicators for Medicare patients (Ly et al 2010).…”

Section: Do Minority Patients Use Lower Quality Hospitals?mentioning

confidence: 99%

Do Minority Patients Use Lower Quality Hospitals?

Gaskin

Spencer

Richard

et al. 2011

INQUIRY

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Employing three years of inpatient discharge data from 11 states and inpatient and patient safety quality indicators from the Agency for Healthcare Research and Quality (AHRQ), this paper explored whether minority (black, Hispanic, and Asian) patients used lower quality hospitals. We found that the association between the share of minority patients and hospital quality depended on how quality was measured and varied by race and ethnicity. Hospitals serving Hispanics performed well on most patient safety measures. Higher percentages of all three minority patient groups corresponded to lower quality for only one measure, postoperative sepsis. Our analysis indicates that it is incorrect to generalize that minorities use lower quality hospitals. Analysts and policymakers should be cautious when making generalizations about the overall service quality of hospitals that treat minority patients.

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“…For example, US minorities encounter unequal access to comprehensive, high-quality health care, inadequate exposure to health promotion and disease prevention, and communication barriers with providers leading to patient distrust. [2][3][4][5][6][7][8][9] Diversity and cultural competency in the health professions workforce are imperative in shaping the skills and attitudes that allow these professionals to work with culturally and ethnically diverse patient populations. 3,5,[10][11][12][13][14][15][16] Moreover, achieving diversity in the workforce is not only fair, it is pragmatic, and will improve minority populations' access to, and receipt of, health care.…”

Section: Introductionmentioning

confidence: 99%

An Educational Program for Underserved Middle School Students to Encourage Pursuit of Pharmacy and Other Health Science Careers

Goldsmith

Tran

2014

American Journal of Pharmaceutical Education

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Objective. To develop and implement an active, hands-on program for underrepresented minority (URM) seventh grade students and to determine if participation in the program increased interest in health care careers and understanding of pharmacy and physician assistant (PA) professions. Design. A hands-on educational program was developed in conjunction with local middle school administrators and staff for URM 7th grade students. The program was designed to be hands-on and focus on pharmacy and PA laboratory skills. A discussion component was included, allowing participants to interact personally with pharmacy and PA students and faculty members. Assessment. Students' responses to survey questions about interest in health care careers and knowledge about health professions were compared before and after 2 separate offerings of the program. After the program, significant increases were seen in participants' understanding of the pharmacy and PA professions. An increased percentage of participants reported interest in health care careers after the program than before the program. Conclusion. Introducing middle school-aged URM students to the pharmacy and PA professions through a hands-on educational program increased interest in, and knowledge of, these professions.

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Mortality After Acute Myocardial Infarction in Hospitals That Disproportionately Treat Black Patients

Cited by 224 publications

References 60 publications

Ethnicity and management of colon cancer in New Zealand

Ethnicity and management of colon cancer in New Zealand

Do Minority Patients Use Lower Quality Hospitals?

An Educational Program for Underserved Middle School Students to Encourage Pursuit of Pharmacy and Other Health Science Careers

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