No significant within-hospital differences seen for quality for Black patients versus White patients
By Lori Solomon HealthDay Reporter
TUESDAY, April 25, 2023 (HealthDay News) — Quality of care for heart failure is largely similar at hospitals caring for a high proportion of Black patients versus other hospitals, according to a study published online April 19 in JAMA Cardiology.
Jamie Diamond, M.D., from the Duke University School of Medicine in Durham, North Carolina, and colleagues assessed whether quality of care for heart failure (in 422,483 patients) differs between hospitals caring for a high proportion of Black patients (96 hospitals) versus other hospitals (384 hospitals).
The researchers found that quality of care was similar between hospitals with high proportions of Black patients compared with other hospitals for 11 of 14 Get With The Guidelines heart failure measures, including use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker/angiotensin receptor neprilysin inhibitors for left ventricle systolic dysfunction (adjusted odds ratio [OR], 0.91; 95 percent confidence interval [CI], 0.65 to 1.27), evidence-based β-blockers (OR, 1.02; 95 percent CI, 0.82 to 1.28), angiotensin receptor neprilysin inhibitors at discharge (OR, 0.74; 95 percent CI, 0.54 to 1.02), anticoagulation for atrial fibrillation/flutter (OR, 1.05; 95 percent CI, 0.76 to 1.45), and implantable cardioverter-defibrillator counseling/placement/prescription at discharge (OR, 0.75; 95 percent CI, 0.50 to 1.13). However, patients treated at high-proportion Black hospitals were less likely to be discharged with a follow-up visit made within seven days or less (OR, 0.68; 95 percent CI, 0.53 to 0.86), to receive cardiac resynchronization device placement/prescription (OR, 0.63; 95 percent CI, 0.42 to 0.95), or to receive an aldosterone antagonist (OR, 0.69; 95 percent CI, 0.50 to 0.97). There were no significant within-hospital differences seen in quality for Black patients versus White patients. For Medicare beneficiaries, risk for 30-day readmissions was higher at high-proportion Black hospitals versus other hospitals (risk-adjusted hazard ratio, 1.14; 95 percent CI, 1.02 to 1.26), but risk was similar for 30-day mortality (hazard ratio, 0.92; 95 percent CI, 0.84 to 1.02).
“These findings suggest Get With The Guidelines can help hospitals achieve equitable care for patients hospitalized with heart failure, an important American Heart Association aim,” a coauthor said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.
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