The nation’s leading GLBT political and medical groups are hoping that a voluntary set of standards and an evaluation dubbed the Healthcare Equality Index (HEI) will help to move healthcare institutions toward fairer, more equitable treatment of GLBT patients and their families.
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Survey methodology guru Ken Sherril. Photo by Bob Roehr
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The first ever HEI survey that lists hospitals by name was conducted by the Human Rights Campaign Foundation (HRC) and the Gay and Lesbian Medical Association (GLMA) and released on May 13. It is modeled after the annual Corporate Equality Index (CEI) survey that HRC has conducted for many years.
Letters were sent to all 6000 hospitals in the U.S. in the fall of 2007 asking them to take a short online survey. The survey itself asked ten GLBT specific questions on policies regarding patient non-discrimination, hospital visitation, decision-making, cultural competency and diversity training, and employee services and benefits.
Some responses were for systems representing more than one facility. In all, the survey represented 88 hospitals or about 1.3 percent of the national total. However, they tended to be larger facilities, so the survey represents about 3 percent of total hospital beds in the country.
About a third of the facilities that responded are operated by Kaiser Permanente, mostly in California, and they all had perfect scores. There were no responses from vast stretches of the South, Plains, and Mountain states, generally areas that offer no legal employment protection based on sexual orientation or gender identity.
‘In America, healthcare is a right, not a privilege,’ Joe Solmonese, president of HRC said in a telephone press conference with reporters. ‘Too often that is not true for gay, lesbian, bisexual, and transgender Americans.’
The lack of federal and often state protections ‘can lead to discrimination and inadequate care,’ he said. By calling attention to discriminatory practices, the groups hope, over time, ‘to establish a gold standard of policies to insure quality for treatment.’
Joel Ginsberg, GLMA’s executive director, said, ‘We want to make sure that LGBT patients going to hospitals receive quality care and that the LGBT healthcare professionals who work within those institutions are able to work in a place where they don’t fear being discriminated against.’
He said hospitals ‘are beginning to realize that LGBT patients represent a population that is affected by health disparities, much like racial and ethnic minorities. We have some unique health issues and we need attention to some of those unique needs.’
Study co-author Tom Sullivan said the goal was establish a baseline and move attitudes and policies over time. He acknowledged that some hospitals chose not to participate this year but rather wait until they get their policy in better shape. He added, ‘We expect the number of participants to grow quickly.’ He also hopes to expand coverage to include nursing home and other healthcare facilities over time.
Hunter College political scientist and survey methodology guru Ken Sherrill said, ‘Those who chose to respond probably were more likely to be good on LGBT issues than those who chose not to respond, so the situation likely is worse than what that depicted in the report.’
He suggested that such a small sample is not representative, but the value of the study should increase over time as more hospitals chose to participate in it.
The U.S. Department of Health and Human Services (HHS) has developed an online database that provides information on outcomes for certain procedures as well as patient satisfaction; see www.hospitalcompare.hhs.gov.
Ginsberg said patients may wish to consult both the HEI and the HHS database in choosing a hospital. There often are trade-offs in considering healthcare decisions.
The full report is available at www.hrc.org/hei; a searchable database should be available in early June.