Hospital Quality Adds to Disparities in Cardiac Surgery
(HealthDay News) – Hospital quality contributes to the racial disparities in outcomes after coronary artery bypass graft (CABG) surgery, according to research published online on Jan. 8 in JAMA Surgery.
Govind Rangrass, MD, of the University of Michigan in Ann Arbor, and colleagues analyzed Medicare data from 173,925 patients to assess the effect of hospital quality on racial disparities in mortality rates following CABG surgery.
The researchers found that risk-adjusted mortality was 33% higher in nonwhite vs. white patients after CABG. Among hospitals with the highest proportion of nonwhite patients (>17.7%), mortality after CABG was 4.8% in nonwhite patients and 3.8% in white patients. When the independent effects of each variable were evaluated, about 35% of the racial disparity in mortality after CABG was explained by variation in hospital quality. Adjustment for differences in socioeconomic status also contributed to the observed disparity, but nonwhite patients still had a 16% higher mortality rate even after both factors were taken into account.
"Hospital quality contributes significantly to racial disparities in outcomes after CABG surgery," the authors write. "However, a significant fraction of this racial disparity remains unexplained."