This study examines racial differences of congestive heart failure (CHF) patients in severity of illness, care-seeking characteristics, and efficiency and outcome of care. A total of 37,970 non-Medicare hospitalized CHF patients were identified from the Nationwide Inpatient Sample Release 6 (1997), collected by Agency for Healthcare Research and Quality (AHRQ). All variables were risk-adjusted. Gender, insurance status, socioeconological condition, and geographic location were controlled. As compared to non-Hispanic whites, minority groups were less likely to have comorbidities. Both AA and Latinos were more likely to be admitted through ER. AA were less likely to go to public hospitals while Latino and other ethnics were more likely. AA were more likely to go to relatively larger hospitals and Latinos were less likely. All minority groups were more likely to go to teaching hospitals or urban hospitals. Latino and other ethnics incurred higher total charges. As compared to whites, AA were less likely to die in hospital and whites were more likely to have undesirable discharge status than were AA and Latinos. A higher mortality risk and a higher undesirable discharge status probability than AA patients were a surprise. This outcome advantage of AA patients was correlated with lower severity-of-illness, more frequent proximity to larger hospitals, to teaching hospitals, and to non-rural hospitals. Public attention should be given to those whites (especially living in rural areas) who are traditionally believed to have better care and outcome, but who may, in fact, be disadvantaged in the case of CHF.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Identify existing racial differences in severity-of-illness, care-seeking characteristics, and efficiency and outcome of care. 2. Assess effects of hospital size and clinical structures on efficiency and outcome. 3. Develop or apply risk-adjustment methods in health services research.
Keywords: Access and Services, Vulnerable Populations
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.