Upstream Factors Associated With Hospitalization in Black- and Minority-Serving Hospitals

Are place-based contextual factors associated with receiving care in a Black-serving hospital, and are the associations modified by race and ethnicity or whether the hospitalization is elective?In this cross-sectional study of data from 8735 respondents to the Medicare Current Beneficiary Survey, neighborhood disadvantage and residential racial segregation were independently associated with hospitalization in a Black-serving hospital. The association differed between Black and White patients, with significantly greater effect sizes for Black patients.These findings suggest that place-based contextual factors are associated with racial disparities in health outcomes through site of care but the association between contextual factors and site of care is modifiable, which warrants further research.

Corresponding Author: Louisa W. Holaday, MD, MHS, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 (louisa.holaday@yale.edu).

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