Variation in inpatient racial composition among acute-care hospitals in New York State

Abstract

This study examined the racial composition of inpatients among 282 short-stay, non-Federal hospitals in New York State. The primary data sources were two inpatient censuses conducted by Blue Cross in late 1975. These were augmented with data from the American Hospital Association's 1975 Annual Survey and the 1970 U.S. Census. Substantial disparity in racial mix was evident. Within New York City, for example, 24 out of 94 hospitals had fewer than 10% nonwhite patients, while 21 hospitals had 50% or more and 7 had 80% or more nonwhites. The proportion of patients covered by Medicaid was found by multiple regression analysis to be a major correlate of the proportion of patients who were nonwhite. Other factors positively associated with the proportion nonwhite included the proportion of patients admitted from the emergency room or outpatient department; presence of a residency program; and availability of family planning services. Analysis of two quality of care indicators revealed that, taking total patient load into account, hospitals with more nonwhite patients tended to have fewer nurses and total assets. In spite of nonwhite gains in access and utilization, the hospital system can still be characterized as 'separate and unequal'. It is suggested that a renewed effort to integrate health care facilities can have a positive impact on both majority and minority populations in this period of fiscal retrenchment.