Performance of racial and ethnic minority-serving hospitals on delivery-related indicators

Andreea A. Creanga, Brian T. Bateman, Jill M. Mhyre, Elena Kuklina, Alexander Shilkrut, William M. Callaghan

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: We sought to explore how racial/ethnic minority-serving hospitals perform on 15 delivery-related indicators, and examine whether indicators vary by race/ethnicity within the same type of hospitals. STUDY DESIGN: We used 2008 through 2011 linked State Inpatient Database and American Hospital Association data from 7 states, and designated hospitals with >50% of deliveries to non-Hispanic white, non-Hispanic black, and Hispanic women as white-, black-, and Hispanic-serving, respectively. We calculated indicator rates per 1000 deliveries by hospital type and, separately, for non-Hispanic white, non-Hispanic black, and Hispanic women within each hospital type. We fitted multivariate Poisson regression models to examine associations between delivery-related indicators and patient and hospital characteristics by hospital type. RESULTS: White-serving hospitals offer obstetric care to an older and wealthier population than black- or Hispanic-serving hospitals. Rates of the most prevalent indicators examined (complicated vaginal delivery, complicated cesarean delivery, obstetric trauma) were lowest in Hispanic-serving hospitals. Generally, indicator rates were similar in Hispanic- and white-serving hospitals. Black-serving hospitals performed worse than other hospitals on 12 of 15 indicators. Indicator rates varied greatly by race/ethnicity in white- and Hispanic-serving hospitals, with non-Hispanic blacks having 1.19-3.27 and 1.15-2.68 times higher rates than non-Hispanic whites, respectively, for 11 of 15 indicators. Conversely, there were few indicator rate differences by race/ethnicity in black-serving hospitals, suggesting an overall lower performance of these hospitals compared to white- and Hispanic-serving hospitals. CONCLUSION: We found considerable differences in delivery-related indicators by hospital type and patients' race/ethnicity. Obstetric care quality measures are needed to track racial/ethnic disparities at the facility and population levels.

Original languageEnglish (US)
Pages (from-to)647.e1-647.e16
JournalAmerican journal of obstetrics and gynecology
Volume211
Issue number6
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

Keywords

  • United States
  • delivery
  • ethnicity
  • quality of care
  • race

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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