Report: Black patients get more bed sores and infections than white patients at the same hospital

Image: Robert Wood Johnson Foundation

Black patients are more likely to suffer hospital injuries such as bed sores and post-surgery health problems than are white patients treated at the same hospital.

An Urban Institute report released Tuesday on disproportionate rates of injury among Black patients is based on discharge records from hospitals in 26 states including North Carolina. The Urban Institute is a nonprofit research organization based in Washington, DC.

The study looked at differences in seven surgery-related complications and four general safety measures. Black patients fared worse for four of the seven surgery-related complications and two of the four general indicators.

“Even when admitted to the same hospital, Black patients experience higher rates of hospital acquired injuries or illnesses occurring during or shortly after surgical procedures relative to white patients,” the report says.

Compared to white patients, Black patients had statistically significant higher rates of respiratory failure after surgery, sepsis, dangerous blood clots in leg veins or lung arteries, and bleeding. Black patients were 18% more likely to go into respiratory failure after surgery and 27% more likely to develop sepsis than white patients treated at the same hospitals.

Black patients were more likely to get bed sores and blood-stream infections related to catheters that reach close to or go inside the heart.

The analysis is based on 2017 data and does not include information from some big states, including Texas, New York, or California.

Racism is at the root of these disparities, said Anuj Gangopadhyaya, the report’s author.

“There’s no way that it’s not,” he said. “The question is, who is the actor? This is a symptom not of one or a handful of actors. It’s a system of racism executed across institutions, across providers, and across payers.”

Other researchers have found that Black children are more likely than white children to die after major surgery. Black patients are more likely to have surgery at hospitals that have higher mortality rates and are located in segregated areas.

The latest Urban Institute report found disparities in how Black and white patients fared when they used the same type of insurance. And hospitals’ overall patient demographics didn’t matter. Black patients had higher rates of surgery-related health problems in hospitals that treated larger shares of Black patients, hospitals that treated smaller shares of Black patients, and in hospitals that had higher proportions of patients with private insurance.

Insurers could play a part in reducing racial disparities, Gangopadhyaya said in an interview.

The federal Centers for Medicare & Medicaid Services has a pay-for-performance program that links Medicare payments to hospital quality. It reduces payments to hospitals with low performance based in part on how often their patients get infections.

Gangopadhyaya said insurers could develop policies that more directly address racial inequities.

Some data on patient outcomes at specific hospitals is publicly available, but information comparing outcomes for patients of different races isn’t easy to find, Gangopadhyaya said.

“If I’m a Black patient, what are the measures for Black patients?” he said. “It’s hard to determine where quality of care is good for patients that look like you or are insured like you.”

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