18 | Washington Adventist Hospital
In-Depth HOSPITAL SETTING AND HEALTH INSURANCE Table 3 shows the hospital settings in which patients were seen at WAH in 2012, by race and ethnicity. For comparison, the last column of Table 3 is identical to the information given in Table 2 above. As in previous years, different patterns of utilization emerge for patients of certain racial/ethnic background. We posit that if race/ethnicity were not associated with the setting in which a patient is seen, the percentages across each row would be similar. For example, Black patients would represent approximately 43 percent of all inpatient visits, 43 percent of all outpatient visits, and 43 percent of all emergency department patients. As Table 3 shows, there are some noteworthy deviations from this expectation. For example, Hispanic patients represent 29 percent of all patient encounters at WAH, yet more than 35 percent of all emergency department visits. White patients, who account for more than 18 percent of all WAH patient encounters, only account for 14 percent of the volume in the emergency department, and 23 percent of outpatient visits. TABLE 3. ALL PATIENT ENCOUNTERS BY HOSPITAL SETTING, WAH, 2012 (N=88,458)
Race/Ethnicity
Inpatient % (N=14,882)
Outpatient % (N=32,405)
Emergency Department % (N=41,171)
ALL WAH Patients % (N=88,458)
Black
41.8
40.7
45.8
43.3
Hispanic
26.2
22.0
35.3
28.9
White
19.4
23.2
14.0
18.3
Asian
3.9
6.8
2.3
4.2
Other
4.3
3.6
1.7
2.8
Unknown
4.4
3.7
0.9
2.5
Top WAH inpatient discharge diagnoses by race/ethnicity For inpatients at WAH, diagnosis-related groups or DRGs relating to childbirth and delivery are among the top five for all patients, regardless of race/ethnicity. Excluding these DRGs, and excluding zero- and one-day stays, the two most common inpatient discharge diagnoses for Black patients at WAH were septicemia and disseminated infections (septicemia) and schizophrenia. For Hispanic patients, the most common diagnoses were major depressive disorder and septicemia; for White patients, they were bipolar disorder and septicemia; and for Asian or Pacific Islander patients, they were schizophrenia and heart failure. Figure 5 shows the hospital settings in which patients were seen at WAH in 2012, by race/ethnicity. Of all the patient encounters with Black patients, nearly half (49%) occurred in the emergency department, which is very close to what we reported last year (48%). Figure 5 also shows that Black patients accounted for 16 percent of inpatients, similar to what was reported in 2012. For both Asian and White patients, the distributions seen in Figure 5 are not significantly different from what has been observed in previous years. For both groups, emergency department patients accounted for less than 40 percent of their respective totals. For all four groups, the distributions are fairly similar to what has been observed in previous years, shifting only a few percentage points.