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Issues And Trends In Healthcare Delivery System01:29

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Hospital Allocation and Racial Disparities in Health Care.

Amitabh Chandra1, Pragya Kakani2, Adam Sacarny3

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The Review of Economics and Statistics
|December 11, 2025
PubMed
Summary
This summary is machine-generated.

Black patients with heart attacks receive care at lower-performing hospitals. However, hospital performance improved, significantly reducing disparities, driven by factors like beta-blocker adoption, not patient reallocation.

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Area of Science:

  • Health services research
  • Health equity
  • Cardiovascular medicine

Background:

  • Racial disparities in healthcare persist, with Black patients often receiving care at lower-quality hospitals.
  • Understanding the drivers of these disparities is crucial for developing effective interventions.

Purpose of the Study:

  • To develop a framework for measuring hospital allocation's role in racial disparities for heart attack patients.
  • To analyze trends in hospital performance and patient allocation over two decades.

Main Methods:

  • Developed a novel framework to quantify hospital allocation's impact on racial disparities.
  • Analyzed data on Black and white heart attack patients' hospital assignments and outcomes.
  • Examined changes in hospital performance and patient reallocation over a 20-year period.

Main Results:

  • Black patients were disproportionately treated at lower-performing hospitals compared to white patients.
  • A significant reduction (over two-thirds) in the hospital performance gap was observed over two decades.
  • This reduction was primarily attributed to rapid performance improvement at hospitals serving Black patients, rather than patient reallocation.
  • Hospital improvement correlated with the adoption of beta blockers.

Conclusions:

  • Hospital performance improvement, particularly linked to the adoption of treatments like beta blockers, is a key driver in reducing racial disparities in heart attack care.
  • While hospital allocation plays a role, focusing on improving care quality at existing facilities is a more effective strategy for disparity reduction.
  • Future efforts should leverage both performance improvement and strategic reallocation to further reduce healthcare inequities.