A home health care worker checks a man's blood pressure
New research offers insight into whether Black patients are getting adequate access to outpatient care. Here, a home health care worker treats a patient. Courtesy UCSF

A new study examines how the pandemic may have worsened inequities in the health care system faced by Black patients.

The findings, based on a look at admissions at a major hospital system, indicate that the crisis exacerbated existing disparities and suggest Black people may have had worse access than whites to outpatient care.

For instance, during the first six months of the pandemic, researchers found that white people at UCLA Health hospitals experienced a far larger drop in admissions for non-COVID conditions as compared to Black patients with similar medical issues.

Better outpatient care could have helped prevent those hospitalizations, said Dr. Richard Leuchter, a resident physician at UCLA Health.

He’s lead author of the study, released Thursday ahead of its publication in the American Journal of Preventive Medicine.

Admissions, for conditions including diabetes, asthma and hypertension, disproportionately expose Black individuals to the financial burdens of missing work and hospital costs. They also faced separations from their families and increased risk of hospital-acquired infections, Leuchter said.

“At a time when large-scale community activism has brought attention to systemic racial injustices, it’s important to bring these inequities to light so that action can be taken,” he said.

“While these findings are limited to UCLA Health, these problems represent a systemwide challenge for health care that cannot be addressed through the actions of a single institution.”

The physician added that it’s “within our power as a society to reallocate resources to combat these serious health inequities. We need widespread community action.”

Consistent with national trends, potentially avoidable hospitalizations dropped across UCLA Health hospitals during the pandemic.

Research into the phenomenon is ongoing, but Leuchter’s study suggests that the potential benefits associated with avoiding hospital stays were not shared equally among all patients.

The researchers examined records for patients admitted to UCLA Health hospitals between March 1 and Aug. 31, 2020. They compared them with hospitalizations during the same pre-pandemic months of 2019.

Patients were admitted for chronic obstructive pulmonary disease, asthma, hypertension, congestive heart failure, community-acquired pneumonia, uncontrolled diabetes and diabetes complications, and urinary tract infections.

People with these conditions can often avoid hospitalization with appropriate outpatient treatment.

The researchers found that out of 4,838 hospitalizations during the 2020 time period, 347 (7.2%)  were potentially avoidable, compared with 557 out of 6,248 (8.9%) hospitalizations during the same six-month period in 2019.

While such hospitalizations dropped by 50% for non-Hispanic whites from 2019 to 2020, they dropped a statistically insignificant 8% for Black patients.

The study has some limitations, researchers said. For instance, it did not take into account factors like comorbidities or socioeconomic status that could contribute to health disparities.

In addition, as the sample was confined to a single health system, there was an assumption that the population pools from 2019 and 2020 were similar.

Some patients also may have received false negatives on COVID-19 tests, leading doctors to admit them for pneumonia, which the study classifies as a potentially avoidable hospitalization.

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