Are There Race/Ethnicity Differences in Outpatient Congestive Heart Failure Management, Hospital Use, and Mortality Among an Insured Population
Bibliographic Data
| ID | 9098902 |
|---|---|
| Authors | Jennifer Elston Lafata (0000-0002-8550-6195, Henry Ford Health System, corresponding author), Manel Pladevall (0000-0002-9359-6055, Center for Health Care Services, corresponding author), George Divine (0000-0002-8465-0523, Henry Ford Health System, corresponding author), Melissa Ayoub, Melissa A Ayoub (Lake Erie College of Osteopathic Medicine), Edward F Philbin (Albany Medical Center Hospital) |
| Year | 2004 |
| Volume | 42 |
| Issue | 7 |
| Pages | 680-689 |
| Publication date | 2004-07-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000129903.12843.fc |
| PMID | 15213493 |
| OpenAlex | W2086860875 |
| Language | EN |
| References cited | 45 |
OBJECTIVE: The objective of this study was to assess the quality of outpatient care received by patients with congestive heart failure (CHF) and whether differences in care and outcomes exist by race/ethnicity. BACKGROUND: Appropriate outpatient CHF management can improve patient well-being and reduce the need for costly inpatient care. Yet, little is known regarding outpatient CHF management or whether differences in this care exist by race/ethnicity. METHODS: Using automated data sources, we identified a cohort of insured patients seen in an outpatient setting for CHF between September 1992 and August 1993. Medical record abstraction was used to confirm diagnosis of CHF. Patients (N = 566) were followed until September 1998. Race/ethnicity differences in outpatient management and medical care utilization were assessed using generalized estimating equations. Differences in mortality and hospitalization for CHF, controlling for patient characteristics and outpatient management, were assessed using Cox and Andersen-Gill models, respectively. RESULTS: With the exception of beta blocker use and primary care visit frequency, few differences by race/ethnicity in patient characteristics and CHF management were found. However, older black patients had more hospital use both at baseline and during follow up. These differences persisted after adjusting for patient characteristics and clinical management. No race/ethnicity differences were found in mortality. CONCLUSIONS: In an insured population, older black patients with CHF have substantially more hospital use than older white patients. This increased use was not explained by differences in CHF outpatient management. Further research is needed to understand why race/ethnicity differences in hospital use are observed among older patients with CHF
Environmental health · Ethnic group · Heart failure · Intensive care medicine · Medical emergency · Political science · Population · Race (biology) · Acute Myocardial Infarction Research · Chronic Disease Management Strategies · Demography · Emergency Medicine · Heart Failure Treatment and Management · Internal Medicine · Medicine · Gerontology
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| Highly cited | No |
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