ArticleHealth affairs (Project Hope)2013
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
Article in Health affairs (Project Hope), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 141 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
141 citing papers in PubMed, 3 syntheses or guidelines pooled it, 299 citations in OpenAlex.
- How Referring Providers Choose Specialists for Their Patients: a Systematic Review.Journal of general internal medicine · 2022Pooled it
- Disparities in Access to Oncologic Care in Pancreatic Cancer: A Systematic Review.Annals of surgical oncology · 2022Pooled it
- The impact of surgeon volume on patient outcome in spine surgery: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Pooled it
- Physician Implicit Racial Bias and Guideline-Concordant Vascular Care.JAMA network open · 2026Article
- Associations Between Neighborhood Social Vulnerability and the Distribution of Rhinologists in the United States.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Perceived Discrimination and Healthcare System Trust as Barriers to Survivorship Care in Endometrial Cancer.Cancer medicine · 2026Article
- Association of hospital quality and social determinants of health with short-term surgical outcomes among medicare beneficiary patients undergoing elective cancer surgery.American journal of surgery · 2026Article
- Hospitals alike, hospitals different: spatial clustering of inequality around Boston's hospitals.Frontiers in sociology · 2026Article
- Chains of Exchange: The Iterative Process of Resource-Health Conversion.Social theory & health : STH · 2026Article
- Association between County Health Rankings Factors and County-level Genitourinary Cancer Mortality.Journal of racial and ethnic health disparities · 2025Article
- Differences in prostate cancer treatment receipt and timeliness of treatment between African American/Black and White Iowans.Cancer causes & control : CCC · 2025Article
- Article
- Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives.Journal of general internal medicine · 2025Article
- Trends in Racial and Ethnic Differences in Declined Surgery for Resectable Malignancies in the United States.Annals of surgery · 2025Article
- Mediation of Ethnic Disparity in the 5-Year Mortality of Cervical Cancer Patients in the US, 2001-2019.Healthcare (Basel, Switzerland) · 2025Article
- Racial and Ethnic Inequalities in Actual vs Nearest Delivery Hospitals.JAMA network open · 2025Article
- Cardio-Oncology and Heart Failure: a Scientific Statement From the Heart Failure Society of America.Journal of cardiac failure · 2025Review
- What explains the growth in hospital assets from 2000 through 2019? A decomposition analysis.Health affairs scholar · 2025Article
- Racial disparities in hospitalization and neighborhood deprivation among Medicare beneficiaries.Health affairs scholar · 2025Article
- Referral Networks, Racial Inequity, and Hospital Quality for Open Heart Surgery.Circulation. Cardiovascular quality and outcomes · 2025Article
81 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
Research has shown that black patients more frequently undergo surgery at low-quality hospitals than do white patients. We assessed the extent to which living in racially segregated areas and living in geographic proximity to low-quality hospitals contribute to this disparity. Using national Medicare data for all patients who underwent one of three high-risk surgical procedures in 2005-08, we found that black patients actually tended to live closer to higher-quality hospitals than white patients did but were 25-58 percent more likely than whites to receive surgery at low-quality hospitals. Racial segregation was also a factor, with black patients in the most segregrated areas 41-96 percent more likely than white patients to undergo surgery at low-quality hospitals. To address these disparities, care navigators and public reporting of comparative quality could steer patients and their referring physicians to higher-quality hospitals, while quality improvement efforts could focus on improving outcomes for high-risk surgery at hospitals that disproportionately serve black patients. Unfortunately, existing policies such as pay-for-performance, bundled payments, and nonpayment for adverse events may divert resources and exacerbate these disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.