While all patients are equal, they are not the same. They may, for example, be exposed to different environments and workplace hazards, have different diets, interact differently with health care providers and face different challenges in complying with medical advice.
For these reasons and many others, some still unknown, patients from traditional racial and ethnic minority groups often receive a lower quality of health care, even when the comparisons control for income and health insurance status.
Health care disparities can lead to increased medical errors, longer hospital stays, avoidable hospital admissions and readmissions, and the over or underutilization of procedures.
The REAL Challenge. Despite our best efforts, we know that race, ethnicity and language (REAL) preference continue to affect the likelihood that patients will receive the care they need and the outcomes they deserve. For example, Hispanic adults with diabetes are far less likely to receive recommended preventive services, and African-American women are more likely to die after they are diagnosed with breast cancer, than their white counterparts.
As health insurance coverage expands, each provider will be challenged to provide the best possible care to a patchwork of patient populations with different beliefs, lifestyles, family structures and support, and health care experiences.
Call to Action. The need to address the problem of health care disparities led to the National Call to Action to Eliminate Health Care Disparities. In 2011, the AHA stood in partnership with America’s Essential Hospitals (formerly the National Association of Public Hospitals and Health Systems), the American College of Healthcare Executives, the Association of American Medical Colleges and the Catholic Health Association of the United States to urge hospitals to speed up action to eliminate health care disparities. To seek the field’s support for action during a time of great change in health care was to acknowledge the urgency of improving equity of care.
The Call to Action focuses on three core areas that we believe will lay the foundation for all hospitals to reduce health care disparities: increased collection of REAL data; broader cultural competency training; and diversity in governance and leadership.
By 2020, we hope to increase collection and use of REAL data to 75%, cultural competency training to 100%, and diversity in governance and leadership teams to 20% and 17%, respectively, or to a composition that reflects the hospital’s community.
Implications for hospital leaders.
Achieving equity in care results in better care and outcomes, higher patient satisfaction, and a deeper and more meaningful connection to the community. Equity of care also has a strong business imperative, a study by the Joint Center for Political and Economic Studies found that eliminating health care disparities for minorities would have reduced direct medical care expenditures by $229.4 billion between 2003 and 2006. As health care transitions to a value-based system of care, hospitals must ensure that their outcomes improve.
Hospitals can act immediately to address equity of care by developing consistent processes to collect and use REAL data. Hospitals should educate all clinical staff during orientation about how to address the unique cultural and linguistic factors affecting the care of diverse patients and communities, and require all employees to attend diversity training. A hospital should work to diversify its board and leadership team to include a voice and perspective that reflect its community.
The mission of the AHA and its members is to advance the health of individuals and communities. We are accountable to the community and committed to health improvement. We cannot succeed unless we eliminate health care disparities.
As a partner in the Call to Action, we will keep the drumbeat steady and work closely with our members to foster success in the realm of equitable care. Equity in care is more than the right thing to do; it’s the smart thing to do – for patients, for communities and for hospitals.
Umbdenstock is president and CEO of the AHA. This is an excerpt of an article that appears in Futurescan 2014: Healthcare Tends and Implications 2014- 2019, a publication of the AHA’s Society for Healthcare Strategy and Market Development. The publication highlights key health care trends and their implications for hospital leaders. To access the publication, click on: http://tinyurl.com/ky662ct. For more information, visit www.shsmd.org.