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Minorities In New York More Likely To Be Treated By Less Competent Surgeons
Racial and ethnic differences in medical care and health outcomes have been widely documented, according to background information in the article. "One specific concern is whether minorities disproportionately receive treatment from lower-quality providers," the authors write. "While measuring quality accurately is difficult, research has shown mortality [death] to be inversely related to hospital and surgeon volume for many surgical procedures."
Andrew J. Epstein, Ph.D., of the School of Public Health, Yale University, New Haven, Conn., and colleagues selected 10 procedures for which published evidence indicates hospital and surgeon volume influences patients' short-term risk of death (including cancer, cardiovascular and orthopedic surgeries). They then studied 133,821 patients in the New York City area who underwent one of these procedures between 2001 and 2004. Annual procedure volumes were calculated for each hospital and surgeon using a statewide database, and thresholds for high-volume vs. low-volume providers and facilities were determined based on previously published research.
Of the patients, 100,798 (75.3 percent) were white, 17,499 (13.1 percent) were black, 4,249 (3.2 percent) were Asian and 11,275 (8.4 percent) were Hispanic. For all ten procedures, white patients were more frequently treated by high-volume surgeons and at high-volume facilities than were black, Asian or Hispanic patients.
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