Who is accountable for racial equity in health care?

摘要

De facto racial segregation is a remarkably prevalent feature of US health care delivery. A national study of Medicare ben- eficiaries hospitalized with acute myocardial infarction in 1994 and 1995 showed that the majority of facilities in die United States admitted no black patients during that 2-year period; 85% of all black acute myocardial infarction patients were admitted to only 1000 of 4690 acute care-hospitals nationwide.2 Nursing homes are even more segregated, with two-thirds of black residents residing in 10% of the homes nationwide.4 Physicians' offices also appear to be sites of de facto segregation: 80% of all primary care visits by black Medicare beneficiaries are made to only 22% of physicians, and physicians serving black patients serve few whites.