Elderly Hispanics throughout the country tend to get inferior care, according to a Harvard study being released Tuesday.
The study, led by Ashish K. Jha of the Harvard School of Public Health, reported that Medicare data from 2004 reveals that hospitals with high percentages of Hispanic patients tend to have slightly lower quality indicators in three crucial areas -- for heart attacks, congestive heart failure and pneumonia.
However, during a teleconference on Monday, Jha acknowledged that the findings may not apply to Miami-Dade County, where 60 percent of the population is Hispanic and Hispanic patients make up the majority of the patients in the region's hospitals.
The Jha study, funded by the Robert Wood Johnson Foundation and published in the March-April edition of Health Affairs, is a follow-up to a similar study last year on African Americans.
''These studies demonstrate a high degree of segregation in the U.S. healthcare system,'' Jha said in a news release.
''Given that a small number of hospitals care for most of the nation's elderly African Americans and elderly Hispanics, efforts to improve care and health outcomes for these minority groups should be very focused,'' Jha said.
More than half of African Americans and Hispanics get treated at only 5 percent of the nation's hospitals, the study found.
The most recent census data, from 2006, indicates 14.8 percent of the country is Hispanic and 12.4 percent is black.
During the conference call, Jha noted that data from the past 20 years shows that minorities tend to get lower quality care in the United States even when adjusted for age, severity of condition, income level and insurance status.
The best known study, of 26 million patients by the federal government's Institute of Medicine in 2002, showed that even after adjusting for all variables, blacks were 3.6 times more likely than whites to have an amputation -- and 2.4 times more likely to be surgically castrated.
Jha said his studies focus on learning why such disparities exist. The findings indicate that in most areas of the country, Hispanics and blacks tend to be treated at hospitals that have a ''much higher percentage of Medicaid'' patients.
Medicaid, the state-federal health insurance for the poor, tends to pay much less for care than does private insurance or Medicare, the program for the elderly and disabled.
Among other things, that means staffing levels are stressed, and each nurse needs to handle more patients, Jha said.
Most experts advocate better funding for Medicaid as one way to handle the disparity problem, but in tough economic times, that's unlikely. Another solution is coming from the Expecting Success program at George Washington University.
Bruce Siegel, a physician who is head of the program, said his group has been able to make some ''dramatic changes'' in the past two and a half years.
The Success program works with hospitals that treat large percentages of minorities to develop systemic programs of scientifically proven care, such as heart attack patients quickly getting a beta blocker.
In one hospital involved in Expecting Success, the percentage of Hispanic patients who received recommended treatment went from 10 percent to over 80 percent, Siegel said.
In addition to national data, the Jha-led studies looked at Miami as one of 30 communities with large minority populations, but did not provide separate statistics for Miami in the study.
Still, Jha noted that Miami-Dade had one of the worst performing hospitals in the national study -- South Beach Community Hospital.
He called South Beach's quality performance ``abysmal.''
In quality measurements for heart attack patients, it scored by far the lowest of all the hospitals in the country that treated a significant number of Hispanic patients, the study showed.
South Beach closed in March 2006, after being battered by accusations of fraudulent billing.
Medicare took the unusual step of refusing to pay for its patients to be treated at the facility, which was known as South Shore for most of its 40-plus year existence.
The hospital is now in bankruptcy.
A bidder is attempting to get state regulators to allow it to re-open the facility, but the state has yet to rule on the application.
Miami Herald staff writer Rob Barry contributed to this report.
