Making a Business Case for Advancing Health Equity in Hospitals
While there is a moral argument for health equity and healthcare as a human right, there is also a business case to be made. Inequitable care is costly and leads to local, regional, and national economic consequences. We've compiled evidence showing that inequities lead to measurable performance and economic consequences to hospitals. Physicians can use this evidence to move hospital leadership toward adoption of an effective health equity infrastructure and work towards closing the health equity gap.
length of stay
Length-of-stay is a common driver of hospital cost and is often a target for quality improvement activities. Non-white patients have an increased length of stay across a variety of conditions. Hospitals that create an effective health equity infrastructure can use existing quality improvement processes to decrease the length of stay in these populations.
- Black patients have a longer postoperative length of stay after elective colorectal surgery.
- Patients with limited english proficiency (LEP) had a longer length of stay after cardiac bypass surgery.
- Non-white patients had longer length of stay after cholecystectomy.
- Black patients have a higher mortality and longer length of stay related to Clostridium difficile infections.
- Black patients hospitalized for ischemic stroke have a longer length of stay as compared to whites.
- African American patients with pneumonia have longer health of stays than white patients.
The Medicare Readmission Reduction Program incentivizes hospitals to decrease 30 day readmission rates. As a result, these readmission rates are closely tracked, and therefore valued by hospital leadership. Similar to length of stay, non-white patients have a higher readmission rate for may common conditions. Creating a health equity infrastructure may allow hospital systems to decrease their readmission rates.
- Black children have a higher rate of readmission for asthma and diabetes than white children.
- Black patients with heart failure had a higher 90 day readmission rate than white patients.
- Black patients who had knee and hip total joint arthroplasty had significantly higher readmission rates as compared to white patients.
- Black patients had a higher rate of readmission and after hip fracture.
- Non-white patients with cirrhosis had a significantly more readmissions than white patients with cirrhosis.