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Unfair Treatment: Racial, Ethnic, and Payer Disparities Persist in Patient Safety

Written by Elizabeth Gilbert

Person Wearing Blue Sterile Gloves

Although every person deserves to receive safe, quality care while in the hospital, this is sadly not everyone’s experience in the U.S.  A recent study from the Leapfrog Group, the Urban Institute, and AARP across 15 states and involving more than 10 million patients has revealed that regardless of a hospital’s safety grade, Black and Hispanic patients experience higher rates of adverse surgery-related events relative to White patients across the board.  This means that even in a hospital that has earned an “A” safety grade, Black and Hispanic patients are more likely to experience dangerous, preventable patient safety problems such as blood clots or sepsis after surgery.

It is known that Black patients are unfortunately more likely to suffer patient safety issues than White patients because Black patients are more likely to be in hospitals with worse patient safety conditions.  Nevertheless, this Leapfrog study raises the important point that even when a Black patient is in the same exact hospital as a White patient, the Black patient is more likely to suffer patient safety problems.  Senior Program Officer at the Robert Wood Johnson Foundation Mona Shah explains, “Studies show the health care system fails Black patients regardless of their age, gender, insurance status or where they access care.  The way care is delivered to diverse patients must fundamentally change and achieving equitable outcomes needs to be a health care priority.”

In addition, publicly insured and uninsured patients are more likely than other patients to be treated unfairly in health care settings because of their coverage type.  As the Leapfrog study made clear, irrespective of hospital safety grade, patients insured by Medicare and Medicaid have significantly higher rates of surgery-related adverse safety events relative to privately insured patients in all hospitals studied.  This was particularly evident in rates for postoperative sepsis and postoperative respiratory failure.  The study authors explained that their analysis “suggests that hospitals deliver safer care to white patients and patients with private insurance coverage.”

What Can Be Done to Address Healthcare Disparities?

Researchers in the area of patient safety propose the following measures to address health inequalities through action on patient safety.

First, individual healthcare professionals may engage in the following measures:

  • “More routine involvement of advocates from patients’ communities in healthcare interactions to reinforce communication and ongoing support in care”
  • “Purposeful consideration of how the social background of a patient may dictate risk of harm from healthcare, and adjust management and follow-up plans accordingly”
  • “Use of culturally and linguistically appropriate shared decision making tools to empower involvement of marginalized patient groups in their care and safety”

Second, healthcare leaders may engage in the following measures:

  • “Support a diverse healthcare leadership that pushes these issues into the consciousness of the workforce and mobilizes the system towards meaningful action”
  • “Race conscious approaches to healthcare education with greater emphasis on racism and discrimination (rather than race) as determinants of disease”
  • “Systematized co-design of clinical services and clinical information with members of marginalized patient communities”

Finally, healthcare systems may engage in the following measures:

  • “Avoid using systematically biased clinical prediction tools and algorithms unless clear empirical justification for race adjustment has been established”
  • “Strengthen capabilities for stratified analysis of patient safety event reports according to important patient characteristics and the translation of these data into tangible action”
  • “Clinical trials must recruit an appropriately diverse cohort, report relevant social determinant characteristics, and conduct relevant stratified analyses that determine effectiveness and safety of drugs and devices”

It is essential that more emphasis is placed on reducing inequalities in patient safety and these proposed measures offer important solutions to achieve this goal.

What Can You Do if You or Your Loved One Suffered from a Patient Safety Issue in the Hospital?

If you or a loved one suffered an injury due to a patient safety issue in the hospital, you should reach out to an attorney right away.  Contact the experienced attorneys at Berkowitz and Hanna, LLC if you have any questions about your legal rights regarding this concern.  To schedule a free, no-obligation consultation, call 203-324-7909 or contact us online today.