Patient diversity: The missing factor in hospital rankings

satisfaction scores

Patients often rely on hospital ratings to decide where they should seek care, but critics have suggested that such metrics must be refined--and in a new commentary, a trio of doctors suggest one potential marker should be patient diversity.

Sociodemographic factors are key to understanding the full picture of care quality, write Henry Ting, M.D., senior vice president and chief quality officer at NewYork-Presbyterian Hospital; George Hripcsak, M.D., chair of biomedical informatics at Columbia University; and David Vawdrey, M.D., vice president of The Value Institute at NewYork-Presbyterian in a column for U.S. News & World Report.

Poor minority patients often face worse outcomes than affluent white patients, so social determinants of health should be part of the hospital ratings equation, they write.

Hospital ratings could include data on how many Medicaid patients are seen, the proportion of patients who are dual eligible under Medicare and Medicaid and the number of Medicare patients that qualify for Supplemental Security Income from the federal government. The authors also point to the number of patients that come through the emergency department and those whose primary language is not English as useful factors in creating a measure for diversity.

“A hospital that welcomes diversity has committed to deliver exceptional care to all patients in their community and population, instead of simply excelling in how to select patients that boost income and ratings," they write. "A hospital that has excellent ratings and embraces diversity is the hospital that every patient would choose.”

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