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The impact of a standardized disease management program on race/ethnicity and gender disparities in care and mortality.

作者信息

Hebert Kathy, Lopez Barbara, Horswell Ron, Tamariz Leonardo, Palacio Ana, Li Hua, Arcement Lee M

机构信息

Div. of Cardiology, Miller School of Medicine, University of Miami, 1611 NW 12th Ave., Jackson Memorial Hospital North Wing 210, Miami, FL 33136, USA.

出版信息

J Health Care Poor Underserved. 2010 Feb;21(1):264-76. doi: 10.1353/hpu.0.0243.

DOI:10.1353/hpu.0.0243
PMID:20173268
Abstract

BACKGROUND

Data on racial and gender differences in mortality in patients followed in a standardized heart failure disease management program (HFDMP) are scarce.

METHODS

Survival was calculated by race/ethnicity and gender for 837 patients enrolled in a HFDMP. (The patients studied were indigent African American and White outpatients [39% African American, 36% female] enrolled into at Leonard J. Chabert Medical Center in Houma, Louisiana.) The hazard ratio associated with demographic and clinical characteristic individually and as a whole, was estimated for the four groups.

RESULTS

White males had the highest mortality (African American female: HR=0.64, African American male: HR=0.65, White female: HR=0.67, p<.05). Age (HR=1.04, p<.001), ejection fraction (HR=0.97, p<.001), New York Heart Association (NYHA) (HR=1.57, p<.001), systolic blood pressure (HR=0.99, p<.05), hematocrit (HR=0.96, p<.01), diabetes (HR=0.98, p<.05), and body mass index (HR=0.98, p<.05) were significant predictors of mortality in the univariate model. Age (HR=1.04, p<.001), NYHA (HR=1.40, p<.001), diabetes (HR=2.52, p<.001), and White female (HR=.44, p<.01) were significant predictors of mortality in the multivariate model.

CONCLUSION

With the exception of White females, who demonstrated lower mortality, amongst African American males and females and White males who participated in a HFDMP no difference in survival was observed.

摘要

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