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      Hospital Allocation and Racial Disparities in Health Care
      04 Jan 2021Working Paper Summaries

      Hospital Allocation and Racial Disparities in Health Care

      by Amitabh Chandra, Pragya Kakani, and Adam Sacarny
      Black Americans experience disparities in health outcomes in the United States relative to other demographic groups. This study of heart attack sufferers over two decades develops a framework to examine the allocation of health care and the effectiveness of medical treatments, including beta-blockers and other technologies.
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      Author Abstract

      We develop a simple framework to measure the role of hospital allocation in racial disparities in health care and use it to study Black and white Medicare patients who are treated for heart attacks—a condition where virtually everyone receives care, hospital care is highly effective, and hospital quality has been validated. We report four facts. (1) Black patients receive care at lower-performing hospitals than white patients, even when they live in the same hospital market or ZIP code within a hospital market. (2) Over the past two decades, the gap in performance between hospitals treating Black and white patients shrank by over two-thirds. (3) This progress is due to more rapid performance improvement at hospitals that tended to treat Black patients, rather than faster reallocation of Black patients to better hospitals. (4) Hospital performance improvement is correlated with adoption of a high-return low-cost input, beta-blockers. Closing remaining disparities in allocation and harnessing the forces of performance improvement, including technology diffusion, may be novel levers to further reduce disparities.

      Paper Information

      • Full Working Paper Text
      • Working Paper Publication Date: November 2020
      • HBS Working Paper Number: NBER Working Paper Series, No. 28018
      • Faculty Unit(s): Technology and Operations Management
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      Amitabh Chandra
      Amitabh Chandra
      Henry and Allison McCance Professor of Business Administration
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