Hospitalist perceptions of health equity in the inpatient setting: A multisite mixed-methods study

Efforts to advance health equity are essential in providing high-quality healthcare. The outpatient setting is where the majority of health equity work has been supported with longitudinal relationships, established metrics, and existing dashboards; similar work in the inpatient setting is lacking.

To understand the perspectives of frontline hospitalists regarding how health equity is approached and measured in the inpatient setting.

We conducted an embedded mixed-methods study using semistructured focus groups and surveys. Participants were members of a national collaborative of hospital medicine groups partnering to improve healthcare delivery. Rapid qualitative methods including templated summaries and matrix analysis were used to identify key themes and subthemes using a mixed inductive and deductive approach.

Twenty-two participants engaged in five focus groups. Three key themes were identified: (1) there is no consensus on how to define and scope health equity in the inpatient setting, (2) organizational support and resources for addressing health equity in inpatient settings are variable, and (3) there is an emotional toll on hospitalists working in the face of health inequities.

Advancing health equity in the inpatient setting is needed and will benefit from embracing clear definitions and scope, broad organizational support, and recognition of its impact on hospitalists.