April 11, 2008
DSC's Racial and Ethnic Disparities series report

disparities groupThe MGH Disparities Solutions Center (DSC) is dedicated to the elimination of racial and ethnic disparities in health care and since its inception has served as a forum for discussion and informative programming. Recently, MGHers gathered in the Trustees Room March 26 for the latest installment of the DSC's Racial and Ethnic Disparities: Keeping Current Seminar Series, featuring Andrew Wilper, MD, of the Cambridge Health Alliance. The discussion focused on Wilper's recently published paper which indicates that African-American and Hispanic patients have longer wait times than white patients to receive treatment in emergency departments (EDs) nationwide.

COMMITTED TO EQUALITY: From left, Alex Green, MD, MPH, of the DSC; Joseph Betancourt, MD, MPH, director of the DSC; Kimbrough-Sugick; and Wilper

The seminar opened with a discussion led by Jessie Kimbrough-Sugick, MD, Aetna/DSC Healthcare Disparities fellow, who provided background on ED health care disparities. She explained that "inequities in care occur across the economic spectrum," but that disparities directly affect EDs because they often serve as health care safety nets for minorities, who are less likely than whites to have health insurance. Kimbrough-Sugick named contributing factors such as a lack of disparities awareness among clinicians, the inconsistent use of evidence-based guidelines in providing care, the lack of diverse workforces in EDs and deficiencies in cultural competence such as a limited availability of interpreter services.

Wilper then described how the treatment of minority patients in EDs reflects the nationwide trend of ED overcrowding: from 1994 to 2004, the number of EDs in the United States decreased by 12 percent even as the number of patients seeking care increased. In discussing why wait times were longer for minorities, Wilper pointed to "gatekeeping" issues such as discriminatory insurance practices that can lead to worse outcomes for patients. According to his research, publicly-funded health care providers also were more likely to discriminate based on race than private institutions.

For more information about the DSC, access www.massgeneral.org/disparitiessolutions. The DSC's next event — an online web seminar, Creating Equity Reports: a Guide for Hospitals — will take place April 24. Registration will take place via the website.

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