Analysis of Quality of Care for Patients Who are Black and Poor in Rural and Urban Settings

by Katherine L. Kahn, Marjorie L. Pearson, Ellen R. Harrison, William H. Rogers, Robert H. Brook, Katherine Desmond, Emmett B. Keeler


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This study finds racial and financial characteristics influence the quality of care received by acutely ill, insured patients after hospital admission. The study uses a clinically detailed data set to examine a comprehensive range of services provided to patients with one of five serious, common diseases in different types of hospitals. The report examines quality of care provided to patients who are black, make use of Medicaid insurance in addition to Medicare, and live in poor neighborhoods, as compared with subsets of patients who are not black, do not have Medicaid insurance, and do not live in poor neighborhoods. It also compares quality of care for inner-city patients and rural patients with that for urban patients who are not poor.

Table of Contents

  • Chapter 1


  • Chapter 2


  • Chapter 3

    Distribution of Patients: Results

  • Chapter 4

    Sickness at Admission: Results

  • Chapter 5

    Process of Care: Results

  • Chapter 6

    Discharge Status: Results

  • Chapter 7

    Outcomes: Results

  • Chapter 8


  • Appendix

  • References

The project was funded by the Health Care Financing Administration (HCFA) and was undertaken in collaboration with the Professional Review Organizations (PROs) in five states.

This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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