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African American, White Heart Failure Patients Receive Same Quality of Care In Veterans Affairs Medical Centers

October 7, 2016

Several studies have shown that there are racial disparities in health care, particularly toward African American patients. The topic was addressed in an Institute of Medicine report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” which found that disparities exist even when access factors, like insurance status and income, are controlled. The report also found that stereotyping, biases, and uncertainty, combined with time pressure and emphasis on cost containment, contributed to disparity occurrences.

In a new study, Farrokh Alemi, Janusz Wojtusiak, and Sorina Vlaicu, all of the Department of Health Administration and Policy, along with Raya Elfadel Kheirbek of Veterans Affairs (VA) Medical Center in Washington, DC and George Washington University’s School of Medicine & Health Sciences, examine whether there is racial disparity in 30-day readmission rates for veterans hospitalized with heart failure. The study is published in Quality Management in Health Care.

“Concerns about racial disparities in health care is just one of many concerns for providers,” said Alemi, the study’s principal investigator. “Heart failure is the leading cause of 30-day readmission rates in the United States. In this secondary data analysis, we sought to determine of there was a difference in 30-day readmission rates among African Americans and Whites.”

The authors did a retrospective secondary data analysis of 65,238 unique patients from 130 VA medical centers. Of those patients, there were 110,482 index heart failure hospitalizations from October 2006 through September 2011.

The analysis showed that at the time of hospitalization, White patients were older and had higher rates of comorbidities and mortality than African American patients. However, once the authors made adjustments for comorbidities, age, and survival rates, African American and White patients had similar 30-day readmission rates.

“Although African American patients tend to present with heart failure at a younger age than White patients, our results determined that both groups of patients received the same quality of care and experienced the same readmission rates once at a VA medical center,” Alemi said. “Our results are important because we removed the confounding in quantitative policy analysis by controlling for these statistical differences to determine if there was any racial disparity between the two groups.”

The study was funded by the Veteran Administration Office of Health Equity.

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