Black patients face worse safety outcomes than white patients at same hospitals, study finds

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Black patients are more likely to experience hospital-acquired illnesses or injuries than white patients within the same hospitals, according to a large analysis from the Urban Research Institute published July 20. 

While the group's earlier research found Black patients are less likely to be admitted to high-quality hospitals and thus experience worse patient safety outcomes, this analysis found the disparities persist even within the same hospitals. 

The report assessed racial disparities in the quality of inpatient care across 11 patient safety indicators. Four of the measures center on general patient safety, while seven are related to surgical procedures. Researchers used discharge records from 2,347 hospitals across 26 states in 2017 to conduct the analysis. 

Black patients experienced significantly worse patient safety outcomes compared to white patients for six of the 11 indicators, including four of the seven surgery-related indicators. 

Overall, Black adults faced higher rates of press ulcers, catheter-related infections, perioperative hemorrhage or hematoma, postoperative respiratory failure, perioperative pulmonary embolism, and postoperative sepsis. 

For example, the rate of sepsis infections after surgery were 1.3 times higher (per 1,000) among Black patients compared to white patients of the same gender and age group. That translates to about a 27 percent difference. 

For pulmonary embolism or deep vein thrombosis, black patients experienced a 30 percent higher rate. 

These trends largely persisted when adjusting for patients' insurance coverage type, and when separating hospitals by those where more than 25 percent of patients are Black. 

At the same time, white patients experienced worse quality of care relative to Black patients on two general patient safety indicators: iatrogenic pneumothorax and an in-hospital fall with a hip fracture. 

"Our previous work suggested increasing the racial diversity of patients that high-quality hospitals serve or concentrating resources to improve quality of care at low-performing hospitals would narrow racial inequities in care," Anuj Gangopadhyaya, PhD, senior research associate at the Urban Institute, said in a news release sent to Becker's. "This study’s findings show that achieving racial equity in patient safety requires transforming the way care is delivered within hospitals as well."

The report outlines several approaches that may mitigate these disparities, including expanding Medicare penalties for hospitals with higher rates of racial care gaps. 


To view the full findings, click here.

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