“Our study reveals that Black patients have worse outcomes largely because they tend to go to hospitals that are underperforming,” study co-author Dr. David Asch said. He is the executive director of the Center for Health Care Innovation at Penn Medicine.
“Because patients tend to go to hospitals close to where they live, these new findings tell a storey of racial residential segregation and reflect our country’s racial history that the pandemic has highlighted,” Asch said in a news release from the University of Pennsylvania School of Medicine.
Asch and his colleagues examined data on over 44,000 COVID-19 Medicare patients treated at nearly 1,200 hospitals in 41 states and the District of Columbia for the study. Nearly 11,000 patients were black, while approximately 33,500 were white.
According to the findings, the 30-day death rate among Black patients was 13.5 percent and just under 13 percent among white patients.
Lower incomes and a higher number of other health issues in Black patients explained some of the difference, but where the patients were treated also played a role, according to the researchers.
According to Dr. Rachel Werner, executive director of Penn’s Institute of Health Economics and study co-author, “People frequently believe that the disparities in mortality between black and white people are due to higher rates of chronic health conditions among black people. However, research has repeatedly shown that where Black patients receive their care is far more important, and that when differences in mortality are taken into account, differences in mortality vanish.”
The researchers ran computer simulations to see what would happen if the study’s black patients were admitted to the same hospitals as the white patients, in the same proportion.
According to the model, the death rate among Black patients would fall from 13.5 percent to 12.2 percent. According to the study’s authors, this translates to a 10% lower risk of death.
The findings were published online in JAMA Network Open on June 17th.
Nazmul Islam, one of the study’s co-authors, works as a statistician at OptumLabs, a division of UnitedHealth Group. “Our analyses show that if Black patients went to the same hospitals as white patients, in the same proportions, we would see equal outcomes,” he said.
Asch continued, “It is intolerable that we live in a society where Black patients are more likely to be admitted to hospitals where they will die. Centuries of racism have brought us to this level of residential segregation, but we can change policies today so that all hospitals are not so reliant on local resources to maintain their quality. COVID-19 has provided a lens through which we can see how far we still have to travel to achieve justice.”