by Bob Roehr
The nation's leading LGBT political and medical groups are hoping that a voluntary set of standards and an evaluation dubbed the Healthcare Equality Index will help to move healthcare institutions toward fairer, more equitable treatment of LGBT patients and their families.
The first ever HEI survey that lists hospitals by name was released on May 13. The Human Rights Campaign Foundation and the Gay and Lesbian Medical Association conducted the study. It is modeled after the annual Corporate Equality Index 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 asked ten LGBT-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. Eighty-eight hospitals responded, accounting for about 1.3 percent of the national total. However, because those that responded tended to be larger facilities, 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, which is based mostly in California. All of their facilities received perfect scores. There were no responses from vast stretches of the South, Plains and Mountain states, which are also areas that generally 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. "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 added. By calling attention to discriminatory practices, HRC, GLMA and other affiliated groups hope, over time, "to establish a gold standard of policies to insure quality for treatment."
Joel Ginsberg, GLMA's executive director, concurred with Solomnese's sentiments. "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.
Ginsberg pointed out that 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," he added.
Study co-author Tom Sullivan said the goal was to 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. "We expect the number of participants to grow quickly," he said. Sullivan and his team also hope to expand coverage to include nursing homes and other healthcare facilities over time.
Hunter College political scientist and survey methodology guru Ken Sherrill said, "Those who chose to response 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 choose to participate in it.
The U.S. Department of Health and Human Services has developed an online database that provides information on outcomes for certain procedures as well as patient satisfaction.
Ginsberg said patients might wish to consult both the HEI and the HHS database in choosing a hospital. There often are tradeoffs in considering healthcare decisions.
The full report is available at http://www.hrc.org/hei. A searchable database should be available in early June.
