This updated fact book from the California Office of Statewide Health Planning and Development (OSHPD) contains analyses of 2007 data on racial and ethnic disparities in health care. The analyses are based on hospital inpatient discharge data reported to OSHPD by all California-licensed hospitals and include access, quality, outcome and utilization measures. Access and quality of care in doctors’ offices, clinics, and other non-hospital settings are assessed by measuring hospitalization rates for medical conditions and complications that can be prevented with proper medical care.
While progress was made for reducing disparities for racial and ethnic populations, disparities increased for treatment of perforated appendix, long- term diabetes complications, congestive heart failure, and adult asthma. Blacks consistently had the worst rates for the outpatient access and quality measures, sometimes two or three times worse rates than Whites, even after adjusting for age and gender differences. And Blacks as hospitalized patients had the lowest utilization rates for coronary artery bypass graft (CABG) surgery and angioplasty when compared to all other races.
The report also notes the ongoing challenges in collecting and analyzing data from smaller racial and ethnic populations. For example, hospitalization rates for Native Americans obtained from California hospital discharge data “can underestimate actual hospitalization rates by more than half their actual values”. And using combined data for Asians and Pacific Islanders “may obscure variations in health status and healthcare utilization across Asian and Pacific Islander populations and do not reflect expected differences in language and cultural practices.”
While the evidence of health care disparities has been well-documented, it is vital to continue monitoring such data to focus quality improvement activities to reduce those disparities.