Date of Conferral

5-5-2025

Date of Award

May 2025

Degree

Ph.D.

School

Health Services

Advisor

Robert Hijazi

Abstract

Underuse of healthcare services by Blacks, who receive fewer influenza vaccinations than Whites in New York, has resulted in elevated health complications and increased healthcare costs. The purpose of this quantitative correlational study was to determine if there is an association between race and insurance status with length of inpatient stay and total charges. Theoretical frameworks were the Quality, Cost, and Health Model and the Institute for Healthcare Improvement Triple Aim framework. Using a dataset from the New York State Planning and Research Cooperative System with a sample size of 3,137 cases, findings showed significant disparities during analysis. Regression analysis demonstrated that White patients had a 42.3% reduced likelihood of needing hospital stays longer than 30 days compared to Black patients (Exp(B) = 0.57, p < .001). Additionally, patients with private insurance were 64% less likely to have an extended length of stay compared to those with government insurance (Exp(B) = 0.36, p < .001). Results also showed White patients incurred $2,550 less in total charges per admission than Black patients (B = -2552.955, p < .001), and private insurance patients paid $8,300 less in charges than government-insured patients (B = -8312.263, p < .001). These findings emphasize the need for policy reforms to improve health equity and reduce financial burdens. Addressing these disparities through preventive care and equitable healthcare delivery can enhance fairness in healthcare operations. The implications for social change include healthcare policy reforms, enhanced community engagement, optimized workflows, and a reduction in preventable mortality.

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