Disparities in the Utilization of High-Volume Hospitals for Complex Surgery

Abstract

There are substantial disparities in the characteristics of patients receiving care at high-volume hospitals. The interest in selective referral to high-volume hospitals should include explicit efforts to identify the patient and system factors required to reduce current inequities regarding their use.

Factors That Influence Minority Use of High-Volume Hospitals for Colorectal Cancer Care

“…In contrast to other studies 22,28 , this study did not find that geographic proximity or insurance explained low minority utilization of HVH. Despite the fact that a higher proportion of racial/ethnic minorities reside within 5 miles of an HVH setting, lower proportions of these patients used it.…”

The Current State of Regionalization in Otolaryngologic Specialized Tumor Care for Tumor Diagnoses

“…In addition, there are no routine screening for head and neck cancers as there are for more common malignancies, and thus patients that are lower income or without private insurance may be presenting with later-stage disease and necessitating treatment at HVFs. Previous literature has similarly shown that patients with lower income or those with non-private insurance types are less likely to seek treatment at HVFs 28,29,36,37 . This aligns with our results, which showed that patients with lower incomes or without private insurance were less likely to be treated at HVFs.…”

“…Previous literature has similarly shown that patients with lower income or those with non-private insurance types are less likely to seek treatment at HVFs. 28,29,36,37 This aligns with our results, which showed that patients with lower incomes or without private insurance were less likely to be treated at HVFs.…”

The Potential Influence of Regionalization Strategies on Delivery of Care for Elective Total Joint Arthroplasty

“…However, patients from vulnerable groups (particularly Medicaid and black patients) are less likely to have access to these high volume institutions. These findings corroborate those from previous authors [7,12,19], but expand upon them by including a diverse group of patients across a spectrum of age and payer mix across 14 states. Lower complication rates indicate better quality of care and provide improved value to payers [23], but policies promoting regionalization should be carefully balanced against the risks of excluding vulnerable patients.…”