ORIGINAL INVESTIGATION Disparities in Health Care Are Driven by Where Minority Patients Seek Care Examination of the Hospital Quality Alliance Measures

Background: Racial/ethnic disparities in health care are well documented, but less is known about whether dis-parities occur within or between hospitals for specific in-patient processes of care. We assessed racial/ethnic dis-parities using the Hospital Quality Alliance Inpatient Quality of Care Indicators. Methods: We performed an observational study using patient-level data for acute myocardial infarction (5 care measures), congestive heart failure (2 measures), com-munity-acquired pneumonia (2 measures), and patient counseling (4 measures). Data were obtained from 123 hospitals reporting to the University HealthSystem Con-sortium from the third quarter of 2002 to the first quar-ter of 2005. A total of 320 970 patients 18 years or older were eligible for at least 1 of the 13 measures