Heart attack death rates found higher in hospitals treating larger share of African Americans

Ninety days after acute myocardial infarction (AMI) -- or heart attack -- death rates for African Americans and white patients were found to be significantly higher in hospitals that disproportionately serve African-American patients than in hospitals that serve mainly white patients, according to a major new study led by researchers at Dartmouth Medical School. The researchers suggest that quality of care, more than racial differences per se, determines AMI outcomes.

Based on the study findings, the investigators assert that targeted quality improvements at hospitals serving large shares of African Americans could enhance AMI care for all patients in those hospitals as well as potentially reduce black-white differences in AMI outcomes overall.

The analysis, published in the October 25, 2005, edition of Circulation: Journal of the American Heart Association, is one of the first to look at the association between the racial composition of a hospital's patients and health outcomes. The study was funded in part by the National Institute on Aging (NIA), a component of the National Institutes of Health, U.S. Department of Health and Human Services. Additional funding was provided by the Robert Wood Johnson Foundation.

"We know that disparities exist in the health and health care of African Americans and whites," explains Richard Suzman, Ph.D., Associate Director of the NIA for Behavioral and Social Research. "Some researchers focus on doctor-patient interactions as the major factor, while others give more weight to hospital quality. Potential remedies are quite different, depending on which set of factors predominates. This study sheds light on the mechanisms that may be at work in the case of hospital care and heart attacks."

Led by Jonathan Skinner, Ph.D., of Dartmouth Medical School, the research team analyzed the records of nearly all fee-for-service Medicare patients who were treated for AMI at U.S. hospitals between January 1, 1

Contact: Vicky Cahan
NIH/National Institute on Aging

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