Special Populations

A health care reform policy in New Jersey that reduced subsidies for medical services to the uninsured and encouraged hospital competition resulted in higher mortality rates for black patients, according to a study in the Journal of General Internal Medicine.

For the study, researchers analyzed discharge data obtained from New Jersey and New York from 1990 through 1996. They looked for in-hospital mortalities stemming from seven conditions:

Hip fracture;
Stroke;
Acute myocardial infarction;
Gastrointestinal bleeding;
Congestive heart failure;
Pneumonia; and
Pulmonary embolism.

The study found that there was no significant change in mortality rates for blacks after instituting New Jersey's Health Care Reform Act, except for acute myocardial infarction, which had a 2.4 percentage point mortality increase.

The authors recommended that policymakers should examine why reforms intended to make hospitals more competitive contributed to racial disparities for some conditions and not others. In addition, the researchers called for cost savings to be examined relative to quality of care to assess the full effects of the new policies (Volpp et al., Journal of General Internal Medicine, November 2006). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.