Dual eligibility, economic well-being, and baseline clinical characteristics accounted for a sizeable portion of postdischarge outcomes
By Lori Solomon HealthDay Reporter
FRIDAY, Dec. 9, 2022 (HealthDay News) — Black patients have a higher risk for 90-day readmission and mortality following percutaneous coronary intervention (PCI) than White patients, according to a study published online Nov. 11 in the American Heart Journal.
Stephanie M. Spehar, M.D., from the University of Michigan in Ann Arbor, and colleagues linked clinical registry data from PCIs performed at 48 Michigan hospitals (January 2013 to March 2018) to Medicare fee-for-service claims to evaluate the risk for 90-day readmission and postdischarge mortality. The analysis included 29,317 patients.
The researchers found that Black patients were more likely than White patients to be readmitted within 90 days of discharge (adjusted odds ratio, 1.62) and had a significantly higher risk for all-cause mortality (adjusted hazard ratio, 1.45) when adjusting for age and gender. Dual eligibility (proportion mediated [PM] for readmission: 11.0 percent; mortality: 21.1 percent); dual eligibility and economic well-being of the patient’s community (PM for readmission: 22.3 percent; mortality: 43.0 percent); and dual eligibility, economic well-being of the community, and baseline clinical characteristics (PM for readmission: 45.0 percent; mortality: 87.8 percent) significantly mediated the associations.
“Our study highlights the need for improved upstream care and streamlined postdischarge care pathways as potential strategies to improve health care disparities in cardiovascular disease,” the authors write.
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