N.Y. quality improvement initiative widened racial health disparities

Modern Healthcare | 7/1/2019 | Staff
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A New York program requiring acute-care hospitals to develop sepsis protocols has improved detection and treatment, but the results weren't as pronounced in hospitals that serve higher proportions of black patients, according to a new study.

Since the program started in 2014, the proportion of patients who underwent the sepsis protocol increased from 61% in 2014 to 72% in 2016, and in-hospital mortality fell from 25% to 21%, according to research published Monday in Health Affairs.

Patients - Increase - Completion - Protocol - Percentage

But black patients experienced the lowest increase in completion of the protocol at only 5 percentage points compared to 6.7 percentage points among Hispanics, 8.4 points among Asians, and 14 points among white patients.

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"If you show up at the same hospital and if you're white or black of Hispanic, we found that you get treated the same with regard to the completion of the sepsis protocol," said study first author Dr. Keith Corl, assistant professor in the division of pulmonary critical care at Brown University's Warren Alpert Medical School. "But the hospitals that care for predominantly minority populations were the hospitals that did not make improvements."

Experts - Policymakers - Hospital - Quality - Care

Experts say federal policymakers should examine whether hospital quality care initiatives may inadvertently exacerbate racial health disparities among minority patient populations.

The study looked at the percentage of patients that received a measurement of lactic acid levels, had blood cultures drawn and received broad-spectrum antibiotics within three hours of presenting at the hospital from April 2014 through June 2016. The three-hour protocol is based on best practice guidelines for managing sepsis first developed in 2004 by the global Surviving Sepsis Campaign and updated every...
(Excerpt) Read more at: Modern Healthcare
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