The authors conducted an observational study to assess racial disparities in best practice patient care between and within 123 hospitals. Best practice was assessed using the Hospital Quality Alliance Inpatient Quality of Care Indicators for acute myocardial infarction (5 care measures), congestive heart failure (2 measures), community-acquired pneumonia (2 measures), and patient counselling (4 measures). In unadjusted analyses, patients from ethnic minorities had significantly poorer care across 8 of 13 quality measures. Differences were greatest with regard to counselling measures. Following adjustment for individual patient characteristics and hospital effect, 3 of 4 counselling measures remained significantly different. The authors conclude that racial differences in receipt of best practice patient care result primarily from the locations in which patients seek care and suggest that policies aimed at reducing disparities should take their underlying causes into consideration.
