Alongside its release on Monday of its annual "Best Hospitals" rankings, U.S. News also unveiled new "health equity measures" for more than 1,400 hospitals nationwide.
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About the new 'health equity measures'—and what they could mean for the future
To determine its health equity measures, U.S. News identified the demographics of Medicare-insured patients who underwent elective procedures at each studied hospital, then compared those to the demographics of the hospital's community.
The aim was to identify any racial gaps between the hospital's patients and the population of the surrounding area.
According to U.S. News, its analysis focused on scheduled procedures to "tease out hospitals visits that were solely based on proximity," since scheduled procedures "are much more responsive to hospital marketing and medical discretion."
The results are listed on each hospital's U.S. News profile, but they did not affect the 2021 "Best Hospital" rankings. However, U.S. News is considering expanding upon its equity measures in the future.
According to Ben Harder, managing editor and chief of health analysis for U.S. News, the publication "is evaluating ways to combine the [current] health equity measures into a future composite index that is applied at the hospital level."
Harder told the Daily Briefing that possible future uses of that "health equity index include developing a standalone evaluation of health equity, which could serve as a useful information tool for patients, and potential inclusion into existing U.S. News Hospitals methodologies."
U.S. News is also considering investigating outcomes of care and social determinants of health, Harder added.
Key findings from this year's analysis
U.S. News found that patients who had common elective procedures—such as joint replacement or cancer surgery—were disproportionately white across the United States.
In fact, according to the analysis, just 29% of hospitals treated a proportion of Black patients comparable to or higher than the proportion of Black residents within the hospitals' local communities, U.S. News found. Similarly, just 18% of hospitals treated a representative share of Hispanic patients, and only 5% of hospitals did so for Asian/Pacific Islander patients.
The analysis also found that, in many areas, compared with similarly insured residents of other races, Black Medicare beneficiaries experienced more potentially avoidable hospitalizations. Specifically, U.S. News found an elevated rate of potentially avoidable hospitalizations among Black residents in Atlanta, Chicago, Dallas, and Philadelphia.
Some hospitals treat a higher proportion of minority patients
Even though most hospitals served a share of minorities disproportionate to their surrounding communities, some hospitals did the opposite, U.S. News found.
For example, at Boston Medical Center, the share of patients who were Black or Hispanic was around double that of the surrounding community. Similarly, in Dallas, where 17% of residents with Medicare are Black and 4% are Hispanic, 40% of patients at Parkland Health and Hospital System were Black and 16% were Hispanic. And Chestnut Hill Hospital, Einstein Medical Center Philadelphia, and Temple University Hospital—all located in Philadelphia—all treated a greater proportion of Black patients than were local residents.
Kate Walsh, CEO of Boston Medical Center, said her organization's patient mix is a result of the hospital's efforts to provide support services to disadvantaged patients, such as a translator, help finding work, or a three-day supply of food.
"You can walk from here to four top-ranked U.S. News hospitals," she said. "I don't think patients we care for come here because we're the closest stop." (Harder et. al., U.S. News & World Report, 7/27; U.S. News & World Report 2021-2022 Best Hospitals Health Equity Measures methodology, accessed 7/27)