Previously, we examined the fact that trauma patients with no insurance may have worse outcomes than the patients with insurance. What about race? Is quality of care being affected by race?

A study published in the Critical Care Medicine Journal determines the correlation between the quality of care for patients with pneumonia and race.

Several previous studies indicated that black patients with severe infections like pneumonia or sepsis receive lower quality of care. These findings, if true, are very disturbing.

The study published in Critical Care looks at the quality of care for patients with pneumonia from a different perspective. Is it the quality of care within the same hospital that is different or the variation is explained by the difference of care between hospitals?

The quality of care, in this study, was defined by the timeliness of intravenous antibiotic administration and by the adherence to the national guidelines for the treatment of pneumonia. The intensity of care including admission to the Intensive Care Unit and mechanical ventilation was also considered.

In crude comparisons, black patients did receive lower quality of care compared to white patients. Looking further into this difference the authors came to the following conclusions:

The differences were primarily attributed to the variability of care between different hospitals. Black patients were more likely to receive care at the hospitals that provided lower quality of care, regardless of race.

In general, hospitals that served a higher number of black patients provided higher intensity of care, including more frequent use of mechanical ventilation.

There was no statistically significant difference in care provided for the patients with pneumonia within the same hospital. Different clustering of white and black individuals among hospitals could explain some of the differences in quality of care found in previous studies.

The findings of this study, even though somewhat encouraging, are still disturbing on another level. A significant variation in the quality of care that is dependent upon the hospital’s geographical location and the predominant race served is unacceptable and should be eliminated.