Public Health

Race and ICU Outcomes

Deaths at intensive care units have declined steadily over the last 10 years, but not if the ICU has large numbers of minority patients.

In a new study, researchers analyzed more 1 million patients at more than 200 hospitals across the United States from 2006 to 2016. Not only was there less improvement in mortality rates in hospitals with large minority patient populations, but the length of stay was longer, too.

“We wanted to know whether racial inequalities, previously described across a range of health care environments, extend into the highest level of care, namely the ICU,” said study author John Danziger, an assistant professor of medicine at Harvard Medical School.

Minority hospitals were defined as hospitals with twice as many minority patients as expected demographically or a hospital where more than 25 percent of the ICU patients were black or Hispanic.

Non-minority hospitals showed a 2 percent decline in ICU deaths each year. Meanwhile, minority hospitals showed no decline in the first few years. Additionally, a large number of critically ill black and Hispanic patients were treated at only 14 of the 200 hospitals.

To avoid bias, gender, age, diagnosis, illness severity and other variables were analyzed in the study. The authors said they couldn’t determine whether the disparities reflected differences in hospital resources or level of care for minority patients. But, they noted, wait times for the ICU were also longer at minority hospitals.

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“The observation that large numbers of critically ill minorities are cared for in poorer performing ICUs gives us an important target for focused research efforts and additional resources to help close the health care divide amongst different minorities in the United States,” Danziger said.

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