2024

Measuring Local-Area Racial Segregation for Medicare Hospital Admissions

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.

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The role of comorbidities,medications, and social determinants of health in understanding urban-rural outcome differences among patients with heart failure

The journal of Rural Health

Emily P. Zeitler, Joanna Joly, Christopher G. Leggett, Sandra L.Wong, A. JamesO’Malley, Sally A. Kraft, Matthew B. Mackwood, Sarah T. Jones,Jonathan S. Skinner

The role of comorbidities, medications, and social determinants of health in understanding urban-rural outcome differences among patients with heart failure.

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Public versus Private Care in the Military Health System: Evidence From Low Back Pain Patients

Military Medicine

Christopher G. Leggett, Rachel O. Schmidt, Jonathan Skinner, Jon D. Lurie, William Patrick Luan

Introduction There is a longstanding debate about whether health care is more efficiently provided by the public or private sector. The debate is particularly relevant to the Military Health System (MHS), which delivers care through a combination of …

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