Black Patients Suffered Worse Patient Safety Outcomes Than White Patients in the Same Hospitals

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By Carol Davis

Black adults experience higher rates of adverse safety events compared to White patients treated in the same hospital, according to a new analysis released today by Urban Institute researchers and funded by the Robert Wood Johnson Foundation.

An adverse safety event is “an injury that was caused by medical management (rather than the underlying disease) and that prolonged the hospitalization, produced a disability at the time of discharge, or both,” as defined by investigators in the Harvard Medical Practice Study.

The Urban Institute analysis looked at quality of care using 11 patient safety indicators and found:

  • In six out of 11 indicators, Black adult patients experienced significantly worse patient safety outcomes compared to White patients in the same age group, of the same gender, and treated in the same hospital.

For Black adults, adverse safety events that involved surgical measures occurred more frequently than general patient safety indicators. Relative to White patients, Black adults experienced higher rates of press ulcers, catheter-related infections, perioperative hemorrhage or hematoma, postoperative respiratory failure, perioperative pulmonary embolism, and postoperative sepsis.

  • Even when comparing patients with similar types of insurance coverage, Black-White disparities in patient safety within the same hospital were prevalent.
  • Black patients experienced worse patient safety events relative to White patients in hospitals that served more Black patients.

Of the six patient safety indicators, safety disparities remained significant across five indicators in hospitals where more than 25 percent of patients were Black.

The Urban Institute’s previous research examined how racial disparities in the quality of inpatient care could be attributed to differences in the quality of hospitals that Black patients are admitted to compared to White patients.

This new analysis, however, indicates that these disparities also exist among Black and White patients treated in the same hospital.
“Our previous work suggested increasing the racial diversity of patients that high-quality hospitals serve or concentrating resources to improve quality of care at low-performing hospitals would narrow racial inequities in care,” said Anuj Gangopadhyaya, senior research associate at the Urban Institute. “This study’s findings show that achieving racial equity in patient safety requires transforming the way care is delivered within hospitals as well.”
“Studies show the healthcare system fails Black patients regardless of their age, gender, insurance status, or where they access care,” said Mona Shah, senior program officer at the Robert Wood Johnson Foundation. “The way care is delivered to diverse patients must fundamentally change and achieving equitable outcomes needs to be a healthcare priority.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.