Racial Health Care Disparities Tied to Insurance

First the good news. According to Newswise, a study looking at claims data from more than 630, 000 patients found no differences in post-operative complications or mortality between African American and White patients, who were treated in a universally insured Military Health System (MHS).

However, African Americans treated in civilian settings, either uninsured or on Medicaid, experienced substantially higher odds of mortality, complications and readmission after surgery, compared to White patients.

The study is titled “Association between race and post-operative outcomes in a universally insured population versus patients in the State of California.” It was published online in Annals of Surgery. The findings suggest that universal insurance could mitigate disparities.

According to the study, African Americans with private insurance had approximately 20% higher odds of experiencing complications, compared to privately insured White patients.

African Americans also experienced approximately 30% higher odds of being readmitted and could expect longer hospital stays—more than 12 hours longer—than privately insured White patients.

In addition, their odds of experiencing complications and readmission were almost twice as high compared to privately insured White patients. The risk for dying among uninsured African Americans and those on Medicaid, was about fourfold.

These disparities were absent among African Americans who were treated directly within Department of Defense hospitals, also known as the TRICARE direct care settings. TRICARE is one of the nation’s largest health insurers, providing care to more than 8 million American military service members, retirees and their dependents.

Tracey Pérez Koehlmoos, Ph.D., M.H.A., an associate professor of Preventive Medicine and Biostatistics at the F. Edward Hébert School of Medicine, in collaboration with Brigham and Women’s Hospital, said, “What we’ve found is that, in a more equitable health system, like the Military Health System, paired with universal insurance, racial disparities could potentially be eliminated. The MHS is an example for the nation.”