Segregated care is less likely at United States (US) hospitals that provide coronary artery bypass grafting (CABG) to large numbers of Black patients and that also employ a high number of health care professionals. These study findings were presented at the American Heart Association (AHA) Scientific Sessions 2021, held virtually from November 13 to 15, 2021.
Black patients who receive CABG are associated with a higher mortality rate if treatment is provided by a hospital with segregated care.
To better assess risk factors for segregated care at American hospitals, researchers from the University of Arizona and University of Michigan sourced data from the Medicare Fee-for-Service 2012-2018 claims database. Risk for receiving high or low segregated care for CABG were evaluated accounting for patient sociodemographic features, comorbidities, hospital, health care professional teams, and hospital service area characteristics.
A total of 312,503 patients cared for at 563 US hospitals were included in the analysis.
The patient population was 84.5% White and 69.9% were men.
Low odds of delivering segregated care were associated with increased number of Black patients receiving CABG (odds ratio [OR], 0.93; 95% CI, 0.90-0.96) and higher number of health care professionals billed (OR, 0.68; 95% CI, 0.59-0.78).
Of interest, the odds of receiving segregated care were not significantly different based on geographic location. Compared with the South, odds in the Northeast (OR, 3.10; 95% CI, 0.53-18.25), West (OR, 1.14; 95% CI, 0.18-7.33), and Midwest (OR, 1.00; 95% CI, 0.27-3.76) were similar.
No significant trends were observed on the basis of year or other patient-, hospital-, and health service area-level features.
The study authors concluded US hospitals that routinely have a high number of Black patients receiving CABG and that employ a larger number of health care professionals were less likely to provide segregated care.
“Dismantling structural racism in healthcare requires investigation of how to replicate cultural and business models of the low segregation hospitals that promote care of diverse patient populations,” the study authors noted.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Breathett K, Hollingsworth J, Shay A, et al. Dismantling structural racism starts with understanding the type of hospitals that provide segregated cardiovascular care. Presented at: AHA Scientific Sessions 2021. Abstract 13616