The analysis confirmed that African-American and Hispanic patients were more likely to receive cardiovascular procedures at lower-volume hospitals. However, statistically adjusting for hospital volume did not significantly close the gap between black and white mortality. Hispanic patients in this database had about the same outcomes as white patients with similar conditions and risk factors.
Dr. Trivedi said that further studies are needed to explain why black patients are more likely to die after cardiovascular procedures.
"The primary limitation of this study is that we used administrative data from hospital discharges and did not have access to detailed clinical information. It is therefore possible that these unmeasured aspects of clinical severity may have partially explained some portion of the relationship between race, volume and post-procedure mortality," he said.
John S. Rumsfeld, M.D., Ph.D., F.A.C.C., from the Denver Veterans Affairs Medical Center and the University of Colorado Health Sciences Center in Denver, who co-authored an editorial in the journal with Andrew J. Epstein, Ph.D., M.P.P. from the Yale School of Public Health in New Haven, Connecticut, said the results of this study indicate that efforts to eliminate racial disparities in cardiovascular outcomes should focus on improving health care quality, not just sending minority patients to higher-volume hospitals.
"The study is important because it points us away from hospital procedure volume alone as a quality metric and as a target for quality improvement to eliminate racial disparities in outcome following cardiovascular procedures," Dr. Rumsfeld said. "At the same time, this study reinforces that there are ra
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Contact: Amy Murphy
amurphy@acc.org
301-581-3476
American College of Cardiology
13-Jan-2006