Not Available for Download

Short- and Long-Term Mortality After an Acute Illness for Elderly Whites and Blacks

Posted: 28 Jun 2007  

Daniel Polsky

University of Pennsylvania - Perelman School of Medicine

Ashish Jha

Harvard University - Department of Health Policy & Management

Judith R. Lave

Graduate School of Public Health

Mark V. Pauly

University of Pennsylvania - Health Care Systems Department; National Bureau of Economic Research (NBER)

Kevin Volpp

University of Pennsylvania

Date Written: 2007

Abstract

Objective: To estimate racial differences in mortality at 30 days and up to 2 years following a hospital admission for the elderly with common medical conditions.

Data Sources: The Medicare Provider Analysis and Review file and the VA Patient Treatment File from 1998-2002 were used to extract patients 65 or older admitted with a principal diagnosis of acute myocardial infarction, stroke, hip fracture, gastrointestinal bleeding, congestive heart failure, or pneumonia.

Study Design: A retrospective analysis of risk-adjusted mortality post-hospital admission for blacks and whites by medical condition and by hospital system.

Principal Findings: Black Medicare patients had consistently lower adjusted 30-day mortality than white Medicare patients, but the initial survival advantage observed among blacks dissipated beyond 30 days and reversed by 2 years. For VA hospitalizations, similar patterns were observed, but the initial survival advantage for blacks dissipated at a slower rate.

Conclusions: Racial disparities in health are more likely to be generated in the post-hospital phase of the process of care delivery rather than during the hospital stay. The slower rate of increase in relative mortality among VA patients suggests an integrated health care delivery system like the VA may attenuate racial disparities in health.

Keywords: Hospital mortality, racial disparities

Suggested Citation

Polsky, Daniel and Jha, Ashish and Lave, Judith R. and Pauly, Mark V. and Volpp, Kevin, Short- and Long-Term Mortality After an Acute Illness for Elderly Whites and Blacks (2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper. Available at SSRN: https://ssrn.com/abstract=995843

Daniel Polsky

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States
215-573-5257 (Phone)
215-898-0611 (Fax)

Ashish Jha (Contact Author)

Harvard University - Department of Health Policy & Management ( email )

677 Huntington Avenue
Boston, MA 02115
United States

Judith R. Lave

Graduate School of Public Health ( email )

130 De Soto Street
Pittsburgh, PA 15261
United States
412 624-0898 (Phone)

Mark V. Pauly

University of Pennsylvania - Health Care Systems Department ( email )

3641 Locust Walk
208 Colonial Penn Center
Philadelphia, PA 19104-6358
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Kevin Volpp

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Paper statistics

Abstract Views
397