Across US Hospitals, Black Patients Report Comparable Or Better Experiences Than White Patients

Abstract

Patient-reported experience is a critical part of measuring health care quality. There are limited data on racial differences in patient experience. Using patient-level data for 2009-10 from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), we compared blacks' and whites' responses on measures of overall hospital rating, communication, clinical processes, and hospital environment. In unadjusted results, there were no substantive differences between blacks' and whites' ratings of hospitals. Blacks were less likely to recommend hospitals but reported more positive experiences, compared to whites. Higher educational attainment and self-reported worse health status were associated with more negative evaluations in both races. Additionally, blacks rated minority-serving hospitals worse than other hospitals on all HCAHPS measures. Taken together, there were surprisingly few meaningful differences in patient experience between blacks and whites across US hospitals. Although blacks tend to receive care at worse-performing hospitals, compared to whites, within any given hospital black patients tend to report better experience than whites do.

Keywords: Determinants Of Health; Disparities; Health Reform; Minority Health; Quality Of Care.

Exhibit 2. Differences between black and white hospital patients in patient experience, adjusted by patients’ characteristics, 2009–10

SOURCE Authors’ analysis of data for 2009–10 from the Hospital Consumer Assessment of Health-care Providers and Systems. NOTES Multivariable regression models were used to adjust for differences between black and white satisfaction scores in self-reported age, sex, health status, education, primary language spoken at home, and reason for admission. Differences for all measures were significant (p < 0.01) except for cleanliness (p = 0.798).