Minority, Medicaid patients underrepresented at NYC's academic medical centers, study finds

Patients with private insurance are significantly more likely to get care at academic medical centers in New York City than those with Medicaid, according to a study published in the International Journal of Health Services.

For the study, researchers analyzed race/ethnicity and insurance coverage of adult inpatients discharged from private academic medical centers in New York City in 2009 and 2014 using data from the Statewide Planning and Research Cooperative System database.

The study revealed Medicaid patients in New York City were less than half as likely as privately insured patients to receive care at an academic medical center. This difference was more marked in 2014, when Medicaid patients were about one-third as likely as those with private insurance to be hospitalized at an academic medical center.

The study also showed white patients were about three times more likely than black patients to be hospitalized an academic medical center in New York City in 2009. In 2014, white patients were still more than twice as likely as black patients to receive care at an academic medical center in New York City.

"Our analyses of adult hospital discharges indicate that minority, uninsured, and Medicaid patients are strikingly underrepresented at NYC's private AMCs," wrote the researchers. "This pattern has not improved — and, regarding insurance status — became even more pronounced after the passage of the ACA."

The researchers noted one limitation to their study was it did not account for patients' diagnoses or severity of illnesses. Academic medical centers' patient populations could be skewed, as they focus on providing care to patients with complex illnesses. "However, we doubt that minority or Medicaid/uninsured patients have lower rates of complex illnesses that might explain their under-representation at NYC AMCs," wrote the researchers.

The full study can be accessed here.

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