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Black Patients More Likely to Have Negative Descriptors in Notes

Compared with White patients, Black patients have 2.54 times the odds of having at least one negative descriptor in EHR

MONDAY, Jan. 24, 2022 (HealthDay News) — Black patients are more likely than White patients to have at least one negative descriptor in the history and physical notes of their electronic health records (EHR), according to a study published online Jan. 19 in Health Affairs.

Michael Sun, from the University of Chicago, and colleagues used machine learning to analyze EHRs from an urban medical center and examined use of negative patient descriptors as a function of patient race or ethnicity. A sample of 40,113 history and physical notes from 18,459 patients from January 2019 to October 2020 were reviewed for sentences containing a negative descriptor (such as resistant or noncompliant) of the patient or their behavior.

The researchers found that compared with White patients, Black patients had 2.54 times the odds of having one or more negative descriptors in the EHR in adjusted models. Patients with Medicaid or Medicare insurance also had higher odds of a negative descriptor compared with those with private or employer-based insurance (adjusted odds ratios, 2.66 and 2.08, respectively). In patient-level sensitivity analyses, Black versus White race was associated with 5.6 additional negative notes per 100 patients.

“This difference may indicate implicit racial bias not only among individual providers but also among the broader beliefs and attitudes maintained by the health care system,” the authors write. “Such bias has the potential to stigmatize Black patients and possibly compromise their care, raising concerns about systemic racism in health care.”

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