Racial bias in health care software aids whites over blacks

Racial bias in health care software aids whites over blacks

A widely used software program that helps guide care for millions of patients is flawed by unintentional racial bias that leads to blacks getting passed over for special care, according to a new study.

The software predicts costs rather than sickness. It is used by U.S. insurers and hospitals to direct higher-cost patients into health care programs designed to help them stay on medications or out of the hospital.

Whites tend to be higher-cost patients even when they’re not as sick as blacks. The study found the software regularly suggested letting healthier white patients into health care risk management programs ahead of blacks who were less healthy because those white patients were more costly.

Fixing the software could more than double the number of black patients enrolled in these programs, said Dr. Ziad Obermeyer of the University of California, Berkeley, who led the research published Thursday in the journal Science.

“The problem was the algorithm was built to predict who’s going to cost money next year, not who’s going to need health care,” said Obermeyer, who studies machine learning in medicine.

The study was based on patient data from one large hospital where blacks cost $1,800 less per year than whites with the same number of chronic illnesses. That’s a pattern seen across the U.S.

The researchers had no financial relationship with the health data company and did not name the company in their paper, but they did share their findings with the company, Obermeyer said.

The company, Optum, acknowledged that its software was the subject of the study and responded Friday, calling the findings “misleading” because hospitals can and should supplement the company’s cost algorithm with their own socio-economic data.

“The cost model is just one of many data elements intended to be used to select patients for clinical engagement programs, including, most importantly, the doctor’s expertise and knowledge of his or her patient’s individual needs,” said Optum spokesman Tyler Mason.

Health insurers have been trying to identify patients with chronic or complex medical conditions and to enrol them in programs that help manage their care. The idea is to cut down on big bills from things like emergency room visits and hospital stays by making sure patients are taking their medicines and keeping up with their health.

A recent analysis of claims from nearly 6 million people covered by employer-sponsored health insurance found that 20% of the population accounted for 84% of the total spending in that group, according to the non-profit Employee Benefit Research Institute.

Other research has tied racial disparities in health care to a cluster of factors including doctors’ unconscious attitudes, blacks’ distrust in the health care system, lack of transportation and poverty.

As big data drives more health care decisions, some experts worry that bias will be further baked into the system. In an accompanying editorial, Ruha Benjamin of Princeton University wrote that older Jim Crow forms of discrimination are feeding into a “New Jim Code” source of bias in “automated systems that hide, speed and deepen racial discrimination behind a veneer of technical neutrality.”

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Police have charged two men after they allegedly tried to break into the Bentley post office with a semi. (Photo courtesy of RCMP)
Red Deer men charged in Bentley post office destruction

Police have charged a pair of Red Deer men after an attempted… Continue reading

Red Deer Fire Chief Ken McMullen remains concerned about “inconsistencies” in the province’s new way of dispatching local ambulances. (Advocate file photo).
A few glitches are already noticed in Red Deer’s new ambulance dispatch system

Local fire-medics need more data about ambulance arrival times

Alberta chief medical officer of health Dr. Deena Hinshaw said the province still hopes to bring the hospitalization number down before relaxing restrictions. (photography by Chris Schwarz/Government of Alberta)
14 new deaths, 366 new COVID-19 cases in Alberta

Province nearing 100K COVID-19 vaccine doses administered

Cervus Equipment is planning to set up a new location near Highways 2 and 42 in Red Deer County. Graphic contributed
Cervus Equipment eyeing new Red Deer County location

Farm equipment busy looking to set up near Highways 2 and 42

Terrance Josephson of the Princeton Posse, at left, and Tyson Conroy of the Summerland Steam clash during a Junior B hockey game at the Summerland Arena in the early spring of 2020. (John Arendt - Summerland Review)
QUIZ: How much do you know about hockey?

Test your knowledge of Canada’s national winter sport

Toronto Maple Leafs goalie Frederik Andersen, left, makes a save on Calgary Flames forward Matthew Tkachuk during second period NHL hockey action in Calgary, Tuesday, Jan. 26, 2021.THE CANADIAN PRESS/Jeff McIntosh
Mitch Marner scores game winner for Maple Leafs in 4-3 win over Flames

Mitch Marner scores game winner for Maple Leafs in 4-3 win over Flames

FILE - In this Oct. 25, 2007, file photo, Boston Red Sox's Curt Schilling pitches against the Colorado Rockies in Game 2 of the baseball World Series at Fenway Park in Boston. Like many baseball writers, C. Trent Rosecrans viewed the Hall of Fame vote as a labor of love. The results of the 2021 vote will be announced Tuesday, Jan. 26, 2021, and Rosecrans was not alone in finding the task particularly agonizing this time around. With Schilling's candidacy now front and center — and Barry Bonds and Roger Clemens still on the ballot as well — voters have had to consider how much a player’s off-field behavior should affect his Hall of Fame chances. (AP Photo/Kathy Willens, File)
Baseball Hall gets no new members; Schilling 16 votes shy

Baseball Hall gets no new members; Schilling 16 votes shy

Prince Edward Island’s Birt is bubble-bound but first wants provincial title

Prince Edward Island’s Birt is bubble-bound but first wants provincial title

Toronto Arrows await word on where they can play, with Plan B going to the U.S.

Toronto Arrows await word on where they can play, with Plan B going to the U.S.

Former CFL player,-coach Brady understands historical significance of NFL promotion

Former CFL player,-coach Brady understands historical significance of NFL promotion

James Hinchcliffe, of Canada, watches during qualifications for the Indianapolis 500 auto race at Indianapolis Motor Speedway, Sunday, Aug. 16, 2020, in Indianapolis. THE CANADIAN PRESS/AP/Darron Cummings
Canadian James Hinchcliffe inks full-time ride with Andretti for 2021 IndyCar season

Canadian James Hinchcliffe inks full-time ride with Andretti for 2021 IndyCar season

Toronto Six down Boston Pride 2-1 for first NWHL victory in franchise history

Toronto Six down Boston Pride 2-1 for first NWHL victory in franchise history

Winnipeg Jets' Andrew Copp (9) celebrates his goal against the Edmonton Oilers during first period NHL action in Winnipeg on Tuesday, Jan. 26, 2021. THE CANADIAN PRESS/Fred Greenslade
Nikolaj Ehlers leads the way, Jets storm back to beat Oilers 6-4

Nikolaj Ehlers leads the way, Jets storm back to beat Oilers 6-4

Most Read