Rationing By Race

We investigate whether racial disparities in health outcomes worsen as hospitals reach capacity, when rationing on the basis of provider and system biases may become more salient. Using time-stamped electronic health records from two large hospitals, we find that in-hospital mortality increased substantially for Black patients when hospitals approached capacity, but not for White patients. Strain-related increases in racial mortality gaps largest for high-risk patients. We provide evidence of rationing on the basis of wait times, documenting a startling fact: sicker Black patients waited longer for care than healthier White patients at all capacity levels.