Examining Racial and Ethnic Disparities in Care at High-Volume Hospitals

Studying the impact of different service providers on racial and ethnic disparities and outcomes

From May 2004 to December 2005, a team of researchers (based for most of the project at the Urban Institute) examined differences among racial and ethnic minorities and Whites in the use of hospitals treating high volumes of patients with certain conditions or of surgeons performing high volumes of certain procedures when high volumes improve outcomes. The researchers analyzed whether such differences in use could explain disparities in health care delivery and outcomes among the different groups of patients.

Key Findings

  • The researchers reported findings in four articles published in peer-reviewed journals:

    • Despite recommendations for greater use of high-volume hospitals, there was only limited movement to those hospitals between 1995 and 2002.
    • Changes in patient awareness about volume-sensitive procedures led to a reduction in the importance of distance and market fragmentation1 in hospital use for several procedures and services.
    • Racial and ethnic minority patients in Greater New York City were less likely than White patients to use high-volume hospitals for most of the procedures measured.
    • Racial and ethnic minority patients in Greater New York City were less likely than White patients to be operated on by high-volume surgeons at high-volume hospitals.

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