Short- and Long-Term Mortality After an Acute Illness for Elderly Whites and Blacks
Posted: 28 Jun 2007
Date Written: 2007
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: Suggested Citation