A recent study of outcomes for common gastrointestinal problems finds that black people may fare better when treated at hospitals with more racially diverse populations.
The study, posted in the American Journal of Gastroenterology and written by clinicians including Philip Okafor, lead author and researcher at the Mayo Clinic in Rochester, Minnesota, found that while black people were about 19 percent more likely than white patients to die or experience severe complications from those ailments, they were 20 percent less likely to do so when treated at facilities that experience a high level of racial diversity.
The analysis is that doctors may provide better care for minorities when they routinely see patients from a wide array of racial and ethnic backgrounds.
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The study also found that even when they black patients make it to the hospital for timely care, their outcomes were worse in hospitals that treated a lower percentage of black patients.
The authors argue that inequalities persist "despite increased awareness and widespread use of evidence-based guidelines in an effort to standardize the care delivery process."
Aside from the level of exposure to a mix of ethnic backgrounds, implicit physician bias was also cited as a possible reason for the discrepancy in care, with findings suggesting that black patients tend to receive better care when tended to by black physicians. How well a hospital performs generally was also considered a likely factor, with data showing that underperforming hospitals typically see worse outcomes for black people than for whites.
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At the hospital level, the majority of patients were white, and the proportion of minorities typically ranged from 26 to 30 percent; hospital charges overall were 36 percent higher for black patients than for white people, but when black patients were seen at hospitals with more diverse populations, their charges were 51 percent lower than if they were seen at hospitals with less diversity.
Black patients also had slightly shorter hospital stays when they were treated at hospitals with more diverse patient populations, which the authors conclude is an indicator of the quality of care -- though the difference was less than a day.
The analysis defined hospital inpatient racial diversity as the percentage of black patients treated in the hospital within a given year.
"Experts have reported that when providers fail to consider social and cultural factors, especially in challenging clinical encounters, they may resort to stereotyping that in turn affects the decision-making process and may unintentionally lead to inequitable treatment to minorities in severe cases," the authors wrote. They stopped short of calling this behavior "racism," however, claiming that these biases are typically "unconscious."
To address the issue, the analysis called on hospital leaders to increase the awareness of unconscious bias among their staffs, and to standardize the care process for patients regardless of race or socioeconomic status.
Specifically, the study focused on cirrhosis and alcoholic hepatitis, gastrointestinal hemorrhages, gastrointestinal obstructions, irritable bowel disease and gallbladder surgery. The data was based on more than 848,000 admissions at almost 3,400 hospitals nationwide.
Twitter: @JELagasse