Health care disparities in this country have a long and deplorable history that still challenges our best efforts now to deliver equitable care to all. Despite the progress we’ve made, much work remains to engage all hospitals in the fight for care equity, develop leadership on reducing disparities, and ensure quality incentives don’t inadvertently work against equity goals.
These are among the key messages in a new package of commentaries on equity of care in the current issue of Frontiers of Health Services Management, a publication of the American College of Healthcare Executives. America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, contributes a thoughtful piece that provides historical context for the issue and a snapshot of association efforts to improve equity.
He tells a sobering tale—a summary of the nation’s sad past with respect to health care for African-Americans and other minorities. His commentary complements a feature article in the same issue about the good work at Baylor Health Care to reduce disparities and another that underscores the need to link health care equity with quality improvement.
Still Much Work to Do
After his brief trip through the history of segregation in hospital care, Siegel tells us what recent data show all too clearly: “We have not come as far as we might think.” He points to data that show continuing wide variation and lingering segregation in U.S. hospitals, as well as in outpatient and nursing home care.
Siegel’s commentary and the others constitute a call to action for all providers to make equitable care a priority, from leadership to frontline staff. We and our members have responded to this call in countless ways over the association’s long history. Our participation in the Equity of Care coalition and work by our Essential Hospitals Engagement Network (EHEN) are among recent examples.
A Priority for All Hospitals
But essential hospitals, alone, can’t solve the problem. “Every hospital and health system in the United States must take up the challenge of reducing care disparities,” Siegel says. This will become particularly important in the context of health care reforms that link payments to quality. Here, though, Siegel urges caution: Policymakers must ensure incentive structures don’t widen care gaps by reducing resources to hospitals that care for our most challenging populations.
The fight to erase care disparities is “far from over,” Siegel concludes. But it is winnable with a commitment by all hospitals to elevate care for all by ensuring high-quality, equitable care for the most vulnerable.