Gray Bradford H, Schlesinger Mark, Siegfried Shannon Mitchell, Horowitz Emily
Urban Institute, 2100 M St., N.W., Washington DC 20037, USA.
Inquiry. 2009 Fall;46(3):322-38. doi: 10.5034/inquiryjrnl_46.03.322.
Differences in the source of care could contribute to racial and ethnic disparities in health status. This study looks at a major metropolitan area and examines racial and ethnic differences in the use of high-volume hospitals for 17 services for which there is a documented positive volume-outcome relationship. Focusing on the hospitalizations of New York City area residents in the periods 1995-1996 and 2001-2002, we found, after controlling for socioeconomic characteristics, insurance coverage, proximity of residence to a high-volume hospital, and paths to hospitalization, that minority patients were significantly less likely than whites to be treated at high-volume hospitals for most volume-sensitive services. The largest disparities were between blacks and whites for cancer surgeries and cardiovascular procedures.
医疗服务来源的差异可能导致健康状况方面的种族和民族差异。本研究着眼于一个主要的大都市地区，考察了在17种已记录有积极的服务量-结果关系的服务中，不同种族和民族在使用高服务量医院方面的差异。以1995 - 1996年和2001 - 2002年纽约市地区居民的住院情况为重点，在控制了社会经济特征、保险覆盖范围、居住地与高服务量医院的距离以及住院途径后，我们发现，对于大多数对服务量敏感的服务，少数族裔患者在高服务量医院接受治疗的可能性显著低于白人。最大的差异存在于黑人和白人在癌症手术和心血管手术方面。
