Racial Disparity Seen with Congenital Heart Surgery
(HealthDay News) — There are poorer medical outcomes in black and Hispanic patients undergoing surgical intervention for congenital heart disease, although mortality is not increased, according to a study published in the December 1 issue of the American Journal of Cardiology.
Frank J. Raucci Jr., MD, PhD, from the University of Virginia in Charlottesville, and colleagues analyzed data from the University Health-System Consortium to assess inpatient resource use by patients with International Classification of Diseases, Ninth Revision, procedure codes representative of Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) classifications 1 through 5 and 6 from 2006–2012 (15,453 pediatric congenital heart disease surgical admissions).
The researchers found that the overall mortality was 4.5 % (689 patients). The total cost of hospitalization, hospital charges, total length of stay, length of intensive care unit stay, and mortality increased with increasing RACHS-1 classification. Black patients (2,034) had higher total costs ($96,884 vs. $85,396 for white patients), higher charges ($318,313 vs. $285,622), and longer length of stay (20.4 vs. 18 days) compared with white patients, even when controlling for RACHS-1 classification. There were similarly disparate outcomes for Hispanic patients ($104,292, $351,371, and 23 days, respectively), and they also had longer stays in the intensive care unit.
"Medical and economic measures increased predictably with increased procedure risk," the authors write.