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Heart Attack Death Rates Higher in Hospitals that Treat Larger Share of African Americans

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A new study finds that there is a direct correlation between the racial composition of a hospital’s patients and their health outcomes.  

Led by researchers at Dartmouth Medical School, the study found that death rates for all patients were significantly higher in hospitals that disproportionately serve African Americans than in hospitals that serve mainly white patients.  The researchers suggest that it is the quality of care, rather than the racial differences, which determines the high death rate.

Led by Jonathan Skinner, Ph.D., of Dartmouth Medical School, the research team analyzed the records of Medicare patients who where treated for heart attacks in U.S. hospitals between January 1997 and September 2001.  More than 1.13 million adults were included in the study.

Skinner and his colleagues classified hospitals that treated Medicare heart attack patients into 10 groups, depending upon the extent to which they served African Americans.  After adjusting for factors such as age, race and sex, the 90-day mortality rate after a heart attack was 20.1% in hospitals serving no African Americans and 23.7% in hospitals with the greatest share of black heart attack patients a 19% higher rate.

The difference in mortality rates was also not explained by factors such as patients’ income, region of the county, or type of hospital ownership.  “We suspected that these differences could have been caused by the higher rates of poverty among the elderly African American population, but this was not the case,” Skinner noted.  He also said the differences could not be attributed to the likelihood of the hospital providing certain post-heart attack surgical interventions, such as coronary artery bypass grafting.  

The study points out that 69% of the African Americans were treated at just 21% of the hospitals.  These hospitals were more likely to be teaching facilities, more likely to be government-run, and less likely to be not-for-profit.

“Our research is consistent with the view that African Americans tend to go to hospitals where everyone gets lower quality care,” Dr. Skinner said.

The study was published in the October 25, 2005 edition of Circulation: Journal of the American Heart Association, and it was funded in part by the National Institute on Aging.

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