Does race matter? active representation in the American healthcare system

Students of representation and the bureaucracy alike have attempted to study the concept of representative bureaucracy. The theory of representative bureaucracy holds that bureaucrats are able to translate the values they acquired as part of their demographic origins into policy outputs that better serve such individuals of the same or similar backgrounds. Sufficient evidence has been found that suggest race and gender as two important demographic characteristics leading to active representation of individuals similar to the bureaucrat's. Such data has been derived from studies involving federal bureaucracies or school districts in the United States. More evidence suggests social class to an important demographic characteristic in other societies. As important as it is, however, scholars have given little credence to the concept of representative bureaucracy with respect to the health care system in the United States. This study, using yearly data from the American Hospital Association and an original survey instrument, calibrates the link between hospital employee race and gender and a number of health performance outputs in these hospitals. The implications of these findings are discussed.