Use of data by hospitals in North Carolina to identify disparities in the care and outcomes of minority patients.

Abstract

Hospitals are now called upon to use available data--information on the use of services, patient satisfaction, and core quality measures--to identify disparities in the use and outcomes of services for minority patients. This study assesses whether and in what ways hospitals in North Carolina use data to understand the experiences of minority patients. Semistructured telephone interviews were completed with chief executive officers (CEOs) and other administrators from a broad sample of North Carolina hospitals. Participants were asked about their hospitals' use of data to compare experiences of minority and nonminority patients and about any other minority-focused initiatives. Responses were analyzed using a grounded theory approach. A total of 28 CEOs and administrators from 17 (77%) of 22 targeted hospitals participated fully in the interviews. Participating hospitals ranged in size from fewer than 60 beds to more than 700 beds and were equally distributed across the state's 3 geographic regions. Three hospitals (18%) reportedly analyzed data by patient race to assess satisfaction, specific clinical outcomes, adverse events, and/or use of services. Respondents cited barriers to analyzing hospital data by patient race and ethnicity as lack of resources, not knowing how to perform these analyses, and not seeing the need. Respondents for 10 hospitals (59%) reported other types of hospital programs targeting the needs of minority patients, including cultural-sensitivity training for staff and initiatives in local communities. Participating hospitals may not reflect all North Carolina hospitals in their minority-focused efforts, and respondents may not have known about all relevant programs in their hospitals. Few hospitals in North Carolina are proactively identifying disparities between minority and nonminority patients by use of data.