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Kai Ryssdal: Over the weekend, the Senate decided, in fact, it’s OK to have a debate about health-care reform. It will start in earnest when Congress reconvenes next Monday. But a lot of the discussion so far has been about changing health insurance. Not necessarily changing health care.
Over the years several studies have shown that minorities tend to receive lower quality care than whites do. That not only increases illness, it also drives up the overall cost of health care. So the Institute of Medicine has issued some recommendations designed to close that quality gap. Ashley Milne-Tyte reports.
ASHLEY MILNE-TYTE: We’re all familiar with the medical forms you fill out at the doctor’s office or when you go to the hospital. Among the questions about allergies and family history, there are usually a few about race, ethnicity and language. Too few, say medical researchers. And the questions don’t go far enough.
Romana Hasnain-Wynia directs the Center for Healthcare Equity at Northwestern’s School of Medicine. She says general labels, like Hispanic, are just a starting point.
Romana Hasnain-Wynia: We have gone one step beyond that and also recommended that granular ethnicity be collected as well.
What she means is that health care providers need to go beyond Hispanic. They should know whether your ancestors came from Mexico or Cuba or both.
Sara Rosenbaum is a professor of law and health policy at George Washington University. She says the more information health-care providers have on patients’ backgrounds, the easier it is to evaluate how different groups fare when they seek health care.
SARA ROSENBAUM: Not in ways that name the patients or name the doctors but that allow us to see patterns in communities and in health care systems.
So health care workers can use that information to see that everyone gets equal care. More data can also lead to better preventive care. That could save billions each year in medical costs.
Romana Hasnain-Wynia says going beyond a broad term like “Asian” can reveal critical information.
Hasnain-Wynia: Do we mean Indian? Do we mean Cambodian, Korean, Chinese, Pakistani and the list goes on.
For example, she says Korean-American women are less likely than other Asian groups to get mammograms. That kind of information could lead to more outreach in Korean communities.
And Cambodian women are far less likely to breastfeed than other new mothers in American hospitals. Cambodian tradition says new mothers should eat specific hot foods after the baby’s born. American hospital food doesn’t fit the bill. So many Cambodian women don’t breastfeed. In one study hospital staff devised a new, Cambodian menu. Breastfeeding tripled.
Language can also be a big barrier to getting proper care. A 2006 study of medical errors found the majority had to do with communication problems. Medical errors can cost more than $50 billion a year.
Ambulances back in and out of the parking area outside the emergency room at Montefiore Medical Center in the Bronx. An elderly lady is wheeled in with an injured leg. Her first language is Spanish. She’s in a lot of pain.
PATIENT: Ay, ay, mami.
Many of the staff at Montefiore speaks Spanish. That makes it more likely that when the woman is released she’ll understand what she needs to do.
Dr. Rhohit Bhalla is chief quality officer at Montefiore. He says hospitals are trying to cut readmission rates, which drive up expenses and can lead to further illnesses. To do that he says you need to study who’s being readmitted. Montefiore is doing just that.
Dr. Rhohit Bhalla: What is our readmission rate for the population let’s say who speaks Spanish versus that who speaks English because you’re trying to get people to take their medications, follow dietary advice, keep their follow-up appointments.
All that involves making yourself understood. Advocates say if all health-care providers carried out these kinds of studies, and knew their patients better, the quality gap in health care would shrink and so would spending.
I’m Ashley Milne-Tyte for Marketplace.
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