JAMA Network Open
Ellesse-Roselee L. Akr., Deanna Chyn, Heather A. Carlos, Amber E. Barnato, Jonathan Skinner
Considerable racial segregation exists in U.S. hospitals which cannot be explained by where patients live. Using 2019 Medicare claims data linked to geographic data, we define a hospital’s market based on ZIP-code based driving time, and estimate the racial composition of all hospitalizations in that market. We then compare the racial composition of the hospital with the racial composition of its market. In our sample of 4.9 million hospital admissions, we find a considerable degree of sorting, with Black Medicare enrollees more likely admitted to some hospitals in their market, and less likely to be admitted to other hospitals nearby. At a regional level, we observed the greatest degree of patient sorting in the New York, Chicago, and Detroit HRRs.