Innovative Tool Assesses Equity in NYC Hospital Care

A recent study conducted by researchers from The City University of New York (CUNY) introduces a novel method for evaluating fairness in healthcare access within New York City hospitals. Published in the journal Health Affairs Scholar, the research unveils the Proportional Share Index (PSI), a straightforward metric designed to determine whether hospitals are serving their fair share of low-income and uninsured patients. The PSI compares the number of Medicaid and uninsured individuals treated by a hospital to the hospital's proportion of available beds citywide.

A PSI score of 1 indicates that a hospital is providing care proportional to its capacity for vulnerable populations. Scores below 1 suggest underrepresentation of Medicaid and uninsured patients, while scores above 1 imply the hospital is caring for more than its expected share of such individuals.

The study's findings reveal that many private, well-funded hospitals in New York, especially large academic medical centers, tend to have PSI scores below 1. This indicates they treat fewer low-income and uninsured patients relative to their capacity. Conversely, public hospitals generally have scores above 1, showing they absorb a larger portion of care for these groups. These disparities contribute to ongoing racial and ethnic health inequities, as Black and Hispanic communities are more likely to be Medicaid or uninsured.

The researchers believe that making PSI data accessible to the public can aid policymakers and communities in holding hospitals accountable and promoting more equitable healthcare coverage across the city. The visualization of hospital fairness via PSI aims to support initiatives that address systemic disparities in health services.

This research was supported by insights from the study "Measuring equitable care in multi-hospital markets: A Proportional Share Index Application in New York City," DOI: 10.1093/haschl/qxaf088. Further details on this innovative approach to evaluating healthcare equity in NYC can be found in the full article.