Identification of racial inequities in access to specialized inpatient heart failure care at an academic medical center

Circulation: Heart Failure

Volumn 12, Issue 11, 2019, Pages

  Eberly, Lauren A ^a,d   Richterman, Aaron ^a   Beckett, Anne G ^a   Wispelwey, Bram ^a   Marsh, Regan H ^a   Cleveland Manchanda, Emily C ^a   Chang, Cindy Y ^a,b   Glynn, Robert J ^a,c   Brooks, Katherine C ^a   Boxer, Robert ^a   Kakoza, Rose ^a   Goldsmith, Jennifer ^a   Loscalzo, Joseph ^a   Morse, Michelle ^a   Lewis, Eldrin F ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^d UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

cardiologist; health equity; heart failure; hospitalization; racism

Indexed keywords

AGED; ARTICLE; CARDIOLOGY SERVICE; CHRONIC KIDNEY FAILURE; CHRONIC LUNG DISEASE; COHORT ANALYSIS; CONTROLLED STUDY; END STAGE RENAL DISEASE; FEMALE; GENERAL PRACTITIONER; HEALTH CARE ACCESS; HEALTH EQUITY; HEART FAILURE; HOSPITAL ADMISSION; HOSPITAL READMISSION; HUMAN; MAJOR CLINICAL STUDY; MALE; MALIGNANT NEOPLASM; OUTCOME ASSESSMENT; RACE DIFFERENCE; RETROSPECTIVE STUDY; UNITED STATES; UNIVERSITY HOSPITAL; URBAN AREA; VALVULAR HEART DISEASE; AFRICAN AMERICAN; CAUCASIAN; COMPARATIVE STUDY; EPIDEMIOLOGY; ETHNOLOGY; HEALTH CARE DELIVERY; HEALTH CARE DISPARITY; HEALTH DISPARITY; HISPANIC; HOSPITAL PATIENT; MASSACHUSETTS; MIDDLE AGED; MORTALITY; RISK ASSESSMENT; RISK FACTOR; TIME FACTOR; TREATMENT OUTCOME; VERY ELDERLY;

ACADEMIC MEDICAL CENTERS; AFRICAN AMERICANS; AGED; AGED, 80 AND OVER; BOSTON; CARDIOLOGY SERVICE, HOSPITAL; EUROPEAN CONTINENTAL ANCESTRY GROUP; FEMALE; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS DISPARITIES; HEALTHCARE DISPARITIES; HEART FAILURE; HISPANIC AMERICANS; HUMANS; INPATIENTS; MALE; MIDDLE AGED; PATIENT ADMISSION; PATIENT READMISSION; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS; TREATMENT OUTCOME;

EID: 85074239047     PISSN: 19413289     EISSN: 19413297     Source Type: Journal    
DOI: 10.1161/CIRCHEARTFAILURE.119.006214     Document Type: Article

References (45)

1. Institute of Medicine Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care 2003 Washington, DC The National Academies Press
2. Jones CP, Levels of racism: A theoretic framework and a gardener's tale. Am J Public Health 2000 90 1212 1215. doi: 10.2105/ajph.90.8.1212
3. Whitehead M, Dahlgren G, Concepts and principles for tackling social inequities in health: levelling up, part 1 2006 Copenhagen WHO Regional Office for Europe
4. Wyatt R, Laderman M, Botwinick L, Mate K, Whittington J, Achieving Health Equity: A Guide for Health Care Organizations 2016 Cambridge, MA Institute for Healthcare Improvement
5. 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. JACC Heart Fail 2016 4 885 893. doi: 10.1016/j.jchf.2016.05.008
6. Rathore SS, Foody JM, Wang Y, Smith GL, Herrin J, Masoudi FA, Wolfe P, Havranek EP, Ordin DL, Krumholz HM, Race, quality of care, and outcomes of elderly patients hospitalized with heart failure. JAMA 2003 289 2517 2524. doi: 10.1001/jama.289.19.2517
7. Alexander M, Grumbach K, Remy L, Rowell R, Massie BM, Congestive heart failure hospitalizations and survival in California: patterns according to race/ethnicity. Am Heart J 1999 137 919 927. doi: 10.1016/s0002-8703(99)70417-5
8. Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB, State of disparities in cardiovascular health in the United States. Circulation 2005 111 1233 1241. doi: 10.1161/01.CIR.0000158136.76824.04
9. Qian F, Parzynski CS, Chaudhry SI, Hannan EL, Shaw BA, Spertus JA, Krumholz HM, Racial differences in heart failure outcomes: evidence from the tele-HF trial (telemonitoring to improve heart failure outcomes). JACC Heart Fail 2015 3 531 538. doi: 10.1016/j.jchf.2015.03.005
10. Lewis EF, Claggett B, Shah AM, Liu J, Shah SJ, Anand I, O'Meara E, Sweitzer NK, Rouleau JL, Fang JC, Desai AS, Retta TM, Solomon SD, Heitner JF, Stamos TD, Boineau R, Pitt B, Pfeffer MA, Racial differences in characteristics and outcomes of patients with heart failure and preserved ejection fraction in the treatment of preserved cardiac function heart failure trial. Circ Heart Fail 2018 11 e004457. doi: 10.1161/CIRCHEARTFAILURE.117.004457
11. Jha AK, Orav EJ, Li Z, Epstein AM, Concentration and quality of hospitals that care for elderly black patients. Arch Intern Med 2007 167 1177 1182. doi: 10.1001/archinte.167.11.1177
12. Shen JJ, Washington EL, Chung K, Bell R, Factors underlying racial disparities in hospital care of congestive heart failure. Ethn Dis 2007 17 206 213
13. Trivedi AN, Nsa W, Hausmann LR, Lee JS, Ma A, Bratzler DW, Mor MK, Baus K, Larbi F, Fine MJ, Quality and equity of care in U.S. hospitals. N Engl J Med 2014 371 2298 2308. doi: 10.1056/NEJMsa1405003
14. Hasnain-Wynia R, Baker DW, Nerenz D, Feinglass J, Beal AC, Landrum MB, Behal R, Weissman JS, Disparities in health care are driven by where minority patients seek care: examination of the hospital quality alliance measures. Arch Intern Med 2007 167 1233 1239. doi: 10.1001/archinte.167.12.1233
15. Hasnain-Wynia R, Kang R, Landrum MB, Vogeli C, Baker DW, Weissman JS, Racial and ethnic disparities within and between hospitals for inpatient quality of care: An examination of patient-level hospital quality alliance measures. J Health Care Poor Underserved 2010 21 629 648. doi: 10.1353/hpu.0.0281
16. Jha AK, Orav EJ, Zheng J, Epstein AM, The characteristics and performance of hospitals that care for elderly hispanic Americans. Health Aff (Millwood) 2008 27 528 537. doi: 10.1377/hlthaff.27.2.528
17. Downing NS, Wang C, Gupta A, Wang Y, Nuti SV, Ross JS, Bernheim SM, Lin Z, Normand ST, Krumholz HM, Association of racial and socioeconomic disparities with outcomes among patients hospitalized with acute myocardial infarction, heart failure, and pneumonia: An analysis of within-And between-hospital variation. JAMA Netw Open 2018 1 e182044. doi: 10.1001/jamanetworkopen.2018.2044
18. Masters J, Morton G, Anton I, Szymanski J, Greenwood E, Grogono J, Flett AS, Cleland JG, Cowburn PJ, Specialist intervention is associated with improved patient outcomes in patients with decompensated heart failure: evaluation of the impact of a multidisciplinary inpatient heart failure team. Open Heart 2017 4 e000547. doi: 10.1136/ openhrt-2016-000547
19. Jong P, Gong Y, Liu PP, Austin PC, Lee DS, Tu JV, Care and outcomes of patients newly hospitalized for heart failure in the community treated by cardiologists compared with other specialists. Circulation 2003 108 184 191. doi: 10.1161/01.CIR.0000080290.39027.48
20. Foody JM, Rathore SS, Wang Y, Herrin J, Masoudi FA, Havranek EP, Krumholz HM, Physician specialty and mortality among elderly patients hospitalized with heart failure. Am J Med 2005 118 1120 1125. doi: 10.1016/j.amjmed.2005.01.075
21. Salata BM, Sterling MR, Beecy AN, Ullal AV, Jones EC, Horn EM, Goyal P, Discharge processes and 30-day readmission rates of patients hospitalized for heart failure on general medicine and cardiology services. Am J Cardiol 2018 121 1076 1080. doi: 10.1016/j. amjcard.2018.01.027
22. Uthamalingam S, Kandala J, Selvaraj V, Martin W, Daley M, Patvardhan E, Capodilupo R, Moore S, Januzzi JL Jr, Outcomes of patients with acute decompensated heart failure managed by cardiologists versus noncardiologists. Am J Cardiol 2015 115 466 471. doi: 10.1016/j.amjcard. 2014.11.034
23. Selim AM, Mazurek JA, Iqbal M, Wang D, Negassa A, Zolty R, Mortality and readmission rates in patients hospitalized for acute decompensated heart failure: A comparison between cardiology and general-medicine service outcomes in an underserved population. Clin Cardiol 2015 38 131 138. doi: 10.1002/clc.22372
24. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Circulation 2017 135 e146 e603. doi: 10.1161/CIR.0000000000000485
25. Crenshaw K, Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Review 1991 43 1241 1299
26. Ford CL, Airhihenbuwa CO, Commentary: just what is critical race theory and what's it doing in a progressive field like public health? Ethn Dis 2018 28 suppl 1 223 230. doi: 10.18865/ed.28.S1.223
27. Ford CL, Airhihenbuwa CO, Critical race theory, race equity, and public health: Toward antiracism praxis. Am J Public Health 2010 100 suppl 1 S30 S35. doi: 10.2105/AJPH.2009.171058
28. DeGuzmán M, Latinx: ¡estamos aquí!, or being "latinx" at UNC-chapel hill. Cult Dyn 2017 29 214 230
29. University of Wisconsin School of Medicine and Public Health Area Deprivation Index. https://www.neighborhoodatlas.medicine.wisc.edu/. Accessed January 5, 2018
30. US Census Bureau 2010 Census. https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed January 5, 2018
31. Zou G, A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004 159 702 706. doi: 10.1093/ aje/kwh090
32. Mickey RM, Greenland S, The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989 129 125 137. doi: 10.1093/oxfordjournals.aje.a115101
33. Parsons S, Reducing bias in a propensity score matched-pair sample using greedy matching techniques. In: The Twenty-Sixth Annual SAS Users Group International Conference 2001 Cary, NC SAS Institute Inc 214 226
34. Drescher CS, Britton KA, Stevenson LW, Desai AS, Clinical outcomes during generalist vs. subspecialty care of inpatients with heart failure and preserved ejection fraction. Card Fail 2017 23 S23. doi:10.1016/j.cardfail.2017.07.047
35. Breathett K, Liu WG, Allen LA, Daugherty SL, Blair IV, Jones J, Grunwald GK, Moss M, Kiser TH, Burnham E, Vandivier RW, Clark BJ, Lewis EF, Mazimba S, Battaglia C, Ho PM, Peterson PN, African Americans are less likely to receive care by a cardiologist during an intensive care unit admission for heart failure. JACC Heart Fail 2018 6 413 420. doi: 10.1016/j.jchf.2018.02.015
36. Cook NL, Ayanian JZ, Orav EJ, Hicks LS, Differences in specialist consultations for cardiovascular disease by race, ethnicity, gender, insurance status, and site of primary care. Circulation 2009 119 2463 2470. doi: 10.1161/CIRCULATIONAHA.108.825133
37. Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, Eng E, Day SH, Coyne-Beasley T, Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. Am J Public Health 2015 105 e60 e76. doi: 10.2105/AJPH.2015.302903
38. Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S, A systematic review of the impact of physician implicit racial bias on clinical decision making. Acad Emerg Med 2017 24 895 904. doi: 10.1111/acem.13214
39. Finucane TE, Carrese JA, Racial bias in presentation of cases. J Gen Intern Med 1990 5 120 121. doi: 10.1007/bf02600511
40. Schrader CD, Lewis LM, Racial disparity in emergency department triage. J Emerg Med 2013 44 511 518. doi: 10.1016/j.jemermed.2012.05.010
41. van Ryn M, Burke J, The effect of patient race and socio-economic status on physicians' perceptions of patients. Soc Sci Med 2000 50 813 828. doi: 10.1016/s0277-9536(99)00338-x
42. Wiltshire J, Cronin K, Sarto GE, Brown R, Self-Advocacy during the medical encounter: use of health information and racial/ethnic differences. Med Care 2006 44 100 109. doi: 10.1097/01.mlr.0000196975.52557.b7
43. Johnson TJ, Hickey RW, Switzer GE, Miller E, Winger DG, Nguyen M, Saladino RA, Hausmann LR, The impact of cognitive stressors in the emergency department on physician implicit racial bias. Acad Emerg Med 2016 23 297 305. doi: 10.1111/acem.12901
44. Daugherty SL, Blair IV, Havranek EP, Furniss A, Dickinson LM, Karimkhani E, Main DS, Masoudi FA, Implicit gender bias and the use of cardiovascular tests among cardiologists. J Am Heart Assoc 2017 6 e006872. doi:10.1161/JAHA.117.006872
45. Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G, Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction: evidence from the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients). Circulation 2018 137 781 790. doi: 10.1161/CIRCULATIONAHA.117.031650