ArticleJournal of general internal medicine2023
Hospitals That Serve Many Black Patients Have Lower Revenues and Profits: Structural Racism in Hospital Financing.
Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Systems Factors Contributing to Racial/Ethnic Disparities in Maternal Health: A Systematic Review.Journal of racial and ethnic health disparities · 2026Pooled it
- Racial Differences in Breast Cancer Survival Between Black and White Women According to Tumor Subtype: A Systematic Review and Meta-Analysis.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Pooled it
- Upstream Factors Associated With Hospitalization in Black- and Minority-Serving Hospitals.JAMA network open · 2026Observational
- Immunotherapy Administration and Survival for Stage IV Melanoma Patients at Minority-Serving Hospitals.Cancer medicine · 2026Article
- Racial and ethnic disparities in access to acute stroke capabilities in California: Association with rurality and telestroke access.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026Article
- Racial disparities in ophthalmology clinical trials: barriers to participation and potential solutions.Eye (London, England) · 2026Review
- Hospitals alike, hospitals different: spatial clustering of inequality around Boston's hospitals.Frontiers in sociology · 2026Article
- Financial venous stasis and thrombosis: A circulatory architecture for frozen capital and high-value care.Northern clinics of Istanbul · 2026Review
- Low Socioeconomic Status at the Patient and Institutional Level Impact Achievement of Breast Cancer Quality Standards.Annals of surgical oncology · 2025Article
- Alternative Approaches to Characterizing Disparate Care by Race, Ethnicity, and Insurance Between Hospitals.International journal of environmental research and public health · 2025Article
- Where you live and where you receive care: Using cross-classified multilevel modeling to examine hospital and neighborhood variation in in-hospital mortality and mortality disparities.Annals of epidemiology · 2025Article
- Impact of Neighborhood Socioeconomic Trajectories on Gastrointestinal Cancer Care: A SEER-Medicare Analysis.Annals of surgical oncology · 2025Article
- Aspects of Patient Safety Culture Most Associated With Employees' Overall Rating of Patient Safety and Whether Employees Reported Safety Events: Overall and for Hospitals Predominantly Serving Black Patients.Journal of patient safety · 2025Article
- Informal Segregation in Health Care Delivery: Historical, Anecdotal, and Objective Evidence.American journal of public health · 2025Article
- Outcomes for Black and White Patients After Certification of Nearby Stroke Centers.JAMA network open · 2025Article
- Disparities in facility-level adoption of minimally invasive interval debulking surgery for advanced ovarian cancer.Gynecologic oncology · 2025Article
- Rising type 2 diabetes mellitus-related mortality among young adults in the United States: a nationwide analysis.Journal of diabetes and metabolic disorders · 2025Article
- COVID-19 infection and sleep health: findings from the nationally representative COVID-19's Unequal Racial Burden survey.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.Health services research · 2025Article
- Outcomes of major cardiac operations are not improved for black patients at black-serving institutions.JTCVS open · 2025Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCare for Black patients is concentrated at a relatively small proportion of all US hospitals. Some previous studies have documented quality deficits at Black-serving hospitals, which may be due to inequities in financial resources for care.
objectiveTo assess disparities in funding between hospitals associated with the proportion of Black patients that they serve.
participantsAll Medicare-participating hospitals, 2016-2018. MAIN MEASURES: Patient care revenues and profits per patient day at Black-serving hospitals (the top 10% of hospitals ranked by the share of Black patients among all Medicare inpatients) and at other hospitals, unadjusted and adjusted for differences in case mix and hospital characteristics. KEY
resultsAmong the 574 Black-serving hospitals, an average of 43.7% of Medicare inpatients were Black, vs. 5.2% at the 5,166 other hospitals. Black-serving hospitals were slightly larger, and were more often urban, teaching, and for-profit or government (vs. non-profit) owned. Patient care revenues and profits averaged $1,736 and $-17 per patient day respectively at Black-serving hospitals vs. $2,213 and $126 per patient day at other hospitals (p<.001 for both comparisons). Adjusted for patient case mix and hospital characteristics, mean revenues were $283 lower/patient day (p<.001) and mean profits were $111/patient day lower (p<.001) at Black-serving hospitals. Equalizing reimbursement levels would have required $14 billion in additional payments to Black-serving hospitals in 2018, a mean of approximately $26 million per Black-serving hospital.
conclusionsUS hospital financing effectively assigns a lower dollar value to the care of Black patients. To reduce disparities in care, health financing reforms should eliminate the underpayment of hospitals serving a large share of Black patients.
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Registered trials
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