12 Jul Black Heart Failure Patients Have More Readmissions and Lower Mortality Than Whites
MedicalResearch.com Interview with:
Matthew Durstenfeld MD
Department of Medicine
Saul Blecker, MD, MHS
Department of Population Health and Department of Medicine
New York University School of Medicine
NYU Langone Medical Center
New York, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Racial and ethnic disparities continue to be a problem in cardiovascular disease outcomes. In heart failure, minority patients have more readmissions despite lower mortality after hospitalization for heart failure. Some authors have attributed these racial differences to differences in access to care, although this has never been proven.
Our study examined patients hospitalized within the municipal hospital system in New York City to see whether racial and ethnic disparities in readmissions and mortality were present among a diverse population with similar access to care. We found that black and Asian patients had lower one-year mortality than white patients; concurrently black and Hispanic patients had higher rates of readmission. These disparities persisted even after accounting for demographic and clinical differences among racial and ethnic groups.
MedicalResearch.com: What should readers take away from your report?
Response: Racial and ethnic disparities in outcomes are still present, even in a municipal health care system that offers care to all. Access to care through a municipal health care system is not enough to eliminate disparities in outcomes. Because municipal health systems take care of a diverse patient population with disparities in outcomes, they may be an ideal setting in which to study interventions to reduce disparities and work toward health equity.
Although our study does not answer the question of why these disparities exist, it suggests that the answer is beyond just access to care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should address specific strategies to reduce disparities. In particular, we need to determine whether quality improvement efforts increase or decrease disparities, particularly those motivated by public reporting or pay-for-performance. In addition, applied research on the implementation of effective strategies to improve care and reduce disparities is needed.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Durstenfeld MS, Ogedegbe O, Katz SD, Park H, Blecker S. Racial and Ethnic Differences in Heart Failure Readmissions and Mortality in a Large Municipal Healthcare System. JCHF.2016;():. doi:10.1016/j.jchf.2016.05.008.
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