As the nation works to overcome healthcare disparities, the U.S. territories are being left out of the discussion. As a result, hospitals in U.S. territories have significantly higher death rates and worse outcomes for patients with acute myocardial infarction (AMI), heart failure (FH) or pneumonia (PNE), than hospitals in U.S. states, concludes a study published online in the Archives of Internal Medicine.
Compared with hospitals in the states, hospitals in Puerto Rico, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands demonstrated worse performance on all core processes measured for AMI, HF and PNE.
In particular, the study found that for every 100 AMI admissions in the U.S. territories there are about two additional deaths, for every 100 HF admissions there is one additional death, and for every 100 pneumonia admissions there are three additional deaths.
"Studies about hospital quality of care in the U.S. typically exclude hospitals in the U.S. territories or combine them with other U.S. regional areas, masking potential differences between quality of care between the territories and states," wrote Marcella Nunez-Smith, M.D., M.H.S., of Yale University School of Medicine.
As one of the first studies to examine quality of care for hospitals located in the U.S. territories, its findings raise concerns about territorial healthcare delivery systems, according to the authors.
"The striking disparity revealed in this study demonstrates that people living in the U.S. territories are at a notable disadvantage compared with those in the U.S. states," note the authors.
However, efforts to eliminate territorial health disparities--and provide care that is at least of the same quality as in the U.S. states--may be challenging, as territories are legally restricted from fully participating in the shaping of national healthcare policy, note the authors.
- here's the study