Blacks Had Lower Inpatient Mortality Rates Than Whites When Hospitalized for Common Medical Conditions, AHRQ Study Finds

Black hospital patients had lower mortality rates than white hospital patients for six common medical conditions, according to a new AHRQ study. Researchers compared data from 2009 on outcomes for heart attack, congestive heart failure, gastrointestinal hemorrhage, hip fracture, pneumonia and stroke. The biggest difference shown, after adjustment for risk factors, was that the black mortality rate for congestive heart failure was about 38 percent less than the white mortality rate (16.6 versus 26.6 deaths per 1,000 hospital stays) and the smallest difference in black and white mortality rates was shown for pneumonia at 5 percent (29.6 versus 31.1 deaths per 1,000 stays). Blacks experienced higher mortality rates, however, for two common surgical procedures, coronary artery bypass graft (13 percent higher) and craniotomy (10 percent higher). Mortality rates were 20 percent lower among blacks for abdominal aortic aneurysm repair, but were similar to whites for percutaneous transluminal coronary angioplasty. The study authors, Roxanne M. Andrews, Ph.D., and Ernest Moy, M.D., used AHRQ’s Inpatient Quality Indicators software to measure risk-adjusted hospital mortality rates. The study, “Racial Differences in Hospital Mortality for Medical and Surgical Admissions: Variations by Patient and Hospital Characteristics,” and abstract were published in the winter 2015 issue of the journal Ethnicity & Disease.

2015 Winter;25(1):90-7.

Racial differences in hospital mortality for medical and surgical admissions: variations by patient and hospitalcharacteristics.

Andrews RM, Moy E.

Abstract

OBJECTIVE:

To determine if there are disparities between White and Black inpatient mortality rates for specific medical and surgical conditions and whether disparities vary by patient and hospital subgroups.

DESIGN, SETTING, PARTICIPANTS:

All-payer discharge records in the 2009 Healthcare Cost and Utilization Project, State Inpatient Databases (SID) for 36 states that comprised about 80% of the Black and White populations in the United States were used to create a random, stratified sample of about 1,900 community hospitals (a 40% sample of US hospitals). All discharges in the hospitals were included and weighted for national estimates.

MAIN OUTCOME MEASURES:

Inpatient Quality Indicators, developed by the Agency for Healthcare Research and Quality, were used to measure risk-adjusted hospital mortality for six medical conditions and four surgeries. National estimates compared non-Hispanic Whites to Blacks by patient and hospital characteristics.

RESULTS:

Blacks had lower mortality for all medical conditions compared to Whites. However, they had higher mortality rates for two surgical procedures (coronary artery bypass graft and craniotomy) and lower mortality for one surgery (abdominal aortic anuerysm repair). These patterns held for most, though not all, patient and hospital subgroups for medical conditions, but disparities typically varied by subgroup for surgeries.

CONCLUSIONS:

Policymakers and researchers may use these findings in targeting interventions, designing quality reporting programs and designing studies on why the disparities exist and how to reduce them.