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患者的医院配置与医疗保健中的种族差异

Hospital Allocation and Racial Disparities in Health Care
Review of Economics and Statistics · 2022 · Amitabh Chandra、Pragya Kakani、Adam Sacarny

中文摘要

我们构建了一个框架,用以衡量患者在医院间的配置对医疗保健中种族差异的影响,并据此研究黑人和白人心脏病发作患者。黑人患者接受治疗的医院绩效低于白人患者接受治疗的医院。然而,在二十年间,治疗黑人患者与治疗白人患者的医院之间的绩效差距缩小了三分之二以上。这一进展源于那些往往收治黑人患者的医院绩效改善得更快,而非患者在医院之间的重新配置。医院绩效改善与采用一种提高生产率的投入——β受体阻滞剂——相关。我们的研究凸显了患者重新配置和医院绩效改善这两种未来缩小差异的杠杆。

Abstract

We develop a framework to measure the role of hospital allocation in racial disparities in health care and use it to study Black and white heart attack patients. Black patients receive care at lower-performing hospitals than white patients. However, over two decades, the performance gap between hospitals treating Black and white patients shrank by over two-thirds. This progress is due to more rapid performance improvement at hospitals that tended to treat Black patients rather than reallocation of patients. Hospital improvement is correlated with adoption of a productivity-raising input, beta blockers. Our work highlights reallocation and performance improvement as future disparity-reduction levers.
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