Healthcare quality improvement programs don't eliminate racial disparities

Despite some improvements, racial disparities affecting black and Hispanic patients persist in U.S. surgical outcomes, even at hospitals participating in a national program aimed at quality improvement, according to a study published in the Annals of Surgery.

Researchers, led by Akshay Sood, M.D., of Henry Ford Hospital's Vattikuti Urology Institute, analyzed data from more than 142,000 patients undergoing one of 16 surgical procedures as part of the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) over a six-year period.

Sood and his team's sample was 85 percent white, 8 percent black and 4 percent Hispanic, with the remainder Asian or another race.

Upon adjusting for numerous variables, the researchers found black patients were at higher risk for a longer hospital stay for 10 of the 16 procedures, while Hispanics were at higher risk for death within 30 days of colon cancer surgery, abdominal aortic aneurysm repair or heart valve repair/replacement, but overall had fewer disparities than black patients.

"Given that the ACS-NSQIP is composed of institutions that emphasize quality-of-care improvement--most of them large academic centers--we thought outcomes for black and other ethnic groups would be similar to those experienced by white patients," Sood said in a statement. "That's not what we found."

Prior research, Sood added, has shown racial disparities narrow when patients are treated at academic medical centers or hospitals participating in quality improvement programs. But, he said, those studies, which focused largely on single procedures or disciplines, were too narrow in scope to paint an accurate picture.

Studies indicate meaningful reduction of racial disparities means looking beyond traditional healthcare interventions, instead targeting community factors such as education, housing and employment. In September the Centers for Medicare & Medicaid Services rolled out a new plan to target outcomes disparities over the next four years, including those based on race, disability and geographic location, FierceHealthcare previously reported

To learn more:
- read the study abstract
- here's the announcement