Performance of racial and ethnic minority-serving hospitals on delivery-related indicators.

Abstract

OBJECTIVE:

We sought to explore how racial/ethnic minority-serving hospitals perform on 15 delivery-related indicators, and examine whether indicators vary by race/ethnicity within the same type of hospitals.

STUDY DESIGN:

We used 2008 through 2011 linked State Inpatient Database and American Hospital Association data from 7 states, and designated hospitals with >50% of deliveries to non-Hispanic white, non-Hispanic black, and Hispanic women as white-, black-, and Hispanic-serving, respectively. We calculated indicator rates per 1000 deliveries by hospital type and, separately, for non-Hispanic white, non-Hispanic black, and Hispanic women within each hospital type. We fitted multivariate Poisson regression models to examine associations between delivery-related indicators and patient and hospital characteristics by hospital type.

RESULTS:

White-serving hospitals offer obstetric care to an older and wealthier population than black- or Hispanic-serving hospitals. Rates of the most prevalent indicators examined (complicated vaginal delivery, complicated cesarean delivery, obstetric trauma) were lowest in Hispanic-serving hospitals. Generally, indicator rates were similar in Hispanic- and white-serving hospitals. Black-serving hospitals performed worse than other hospitals on 12 of 15 indicators. Indicator rates varied greatly by race/ethnicity in white- and Hispanic-serving hospitals, with non-Hispanic blacks having 1.19-3.27 and 1.15-2.68 times higher rates than non-Hispanic whites, respectively, for 11 of 15 indicators. Conversely, there were few indicator rate differences by race/ethnicity in black-serving hospitals, suggesting an overall lower performance of these hospitals compared to white- and Hispanic-serving hospitals.

CONCLUSION:

We found considerable differences in delivery-related indicators by hospital type and patients' race/ethnicity. Obstetric care quality measures are needed to track racial/ethnic disparities at the facility and population levels.

• Authors: Andreea A Creanga, Brian T Bateman, Jill M Mhyre, Elena Kuklina, Alexander Shilkrut, William M Callaghan
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 211 Issue 6 Pg. 647.e1-16 (Dec 2014) ISSN: 1097-6868 [Electronic] United States
• PMID: 24909341 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Inc.

Topics

• Adult
• Black or African American (statistics & numerical data)
• Age Distribution
• Cesarean Section (statistics & numerical data)
• Cohort Studies
• Delivery, Obstetric (statistics & numerical data)
• Ethnicity (statistics & numerical data)
• Female
• Hispanic or Latino (statistics & numerical data)
• Hospital Mortality
• Hospitals (classification, standards, statistics & numerical data)
• Humans
• Hysterectomy (statistics & numerical data)
• Income (statistics & numerical data)
• Minority Groups (statistics & numerical data)
• Multivariate Analysis
• Peripartum Period
• Poisson Distribution
• Postoperative Complications (epidemiology)
• Pregnancy
• Puerperal Infection (epidemiology)
• Quality Indicators, Health Care (statistics & numerical data)
• Regression Analysis
• Retrospective Studies
• United States (epidemiology)
• Uterine Rupture (epidemiology)
• White People (statistics & numerical data)
• Young Adult