- 2012elections - 9/11 Special Coverage - aca - africanamericanalzheimers - aids - Alabama News Network - american - Awards & Expo - bees - bilingual - border - californiaeducation - Caribbean - cir - citizenship - climatechange - collgeinmiami - community - democrats - ecotourism - Elders - Election 2012 - elections2012 - escuelas - Ethnic Media in the News - Ethnicities - Events - Eye on Egypt - Fellowships - food - Foreclosures - Growing Up Poor in the Bay Area - Health Care Reform - healthyhungerfreekids - howtodie - humiliating - immigrants - Inside the Shadow Economy - kimjongun - Latin America - Law & Justice - Living - Media - memphismediaroundtable - Multimedia - NAM en Espaol - Politics & Governance - Religion - Richmond Pulse - Science & Technology - Sports - The Movement to Expand Health Care Access - Video - Voter Suppression - War & Conflict - 攔截盤查政策 - Top Stories - Immigration - Health - Economy - Education - Environment - Ethnic Media Headlines - International Affairs - NAM en Español - Occupy Protests - Youth Culture - Collaborative Reporting

Blacks Benefit Less From Teaching Hospitals

The Philadelphia Tribune, News Report, Posted: Feb 27, 2009

A recent study suggested elderly white patients benefit more than Blacks in surviving surgical complications at teaching hospitals.

We found an advantage in surgical outcomes for patients in teaching intensive hospitals compared to non-teaching hospitals, as we had expected from other studies, said the studys leader Dr. Jeffery H. Silber director of the Center for Outcomes Research at The Childrens Hospital of Philadelphia and a professor at the University of Pennsylvania.

What we didnt expect was that better outcomes in teaching hospitals occurred for white patients but not for Black patients.

He noted the survival advantage from teaching hospitals came from lower death rates after complications, not from lower complication rates.

The study appeared in the February issue of the Archives of Surgery.

The study group analyzed Medicare claims from 4.6 million patients aged 65 to 90 admitted for general, orthopedic and vascular surgery at 3,270 acute care hospitals in the United States from 2000 to 2005. Hospitals were classified as non-teaching hospitals if they had no residents and teaching hospitals were scaled by their ratio of residents to hospital beds.

The researchers measured mortality 30 days after surgery, in hospital complications and failure-to-rescue, defined as the probability of death following complications. They found that compared to non-teaching hospitals, hospitals with the highest ratio of residents to beds had 15 percent lower mortality after surgery, no difference in complications and 15 percent lower odds of death after complications. These benefits were observed in white patients, not Black patients. For Black patients, the odds of death, complication and failure to rescue were similar at both teaching and non-teaching hospitals.

Silbers group did not find lower rates of complications in teaching-intensive hospitals.

Overall, the improved survival rates were not because patients were less likely to have complications, but because they were less likely to die from those complications in teaching hospitals, said Silber, who first developed failure-to-rescue as a quality of care measure more than a decade ago.

Black patients displayed higher complication rates than white patients at both teaching and non-teaching hospitals, though there were no difference in complication rates between teaching and non-teaching hospitals for both Black or white patients.

While white patients at teaching hospitals experienced better survival rates after complications than Black patients when compared to non-teaching hospitals, Black patients experienced the same survival after complications at both types of hospitals.

The researchers found this racial disparity existed not only across different hospitals, but also for white and Black patients within the same hospitals.

We dont yet know why these racial disparities exist in surgical outcomes, but we have some working hypotheses, Silber said.

His group offers possible explanations including unintentional differences in communication between patients and providers. In previous work, Silber and colleagues found that surgical procedures take longer for Black patients than white patients in some hospitals.

That finding raised the question of whether less experienced physicians might be more often operating on Black patients, Silber said.

Silber noted the current study relied on Medicare claims data, not on detailed medical records, so it did not provide specific information on patient care that might shed light on the reasons for the observed racial disparities.

Our findings provide a starting point for further studies of detailed patient care that might shed light on why these disparities exist and how they could be reduced, he said.

Funding for the study came from the National Heart, Lung and Blood Institute of National Institutes of Health, the U.S. Department of Veterans Affairs and the National Science Foundation. Siblers co-authors were from Childrens Hospital; the University of Pennsylvania; Veterans Administration Hospital, Philadelphia; the University of California Davis School of Medicine; Boston University School of Public Health; and the Veterans Administration Hospital, Boston.

Related Articles:

Hispanic CEOs Take Stock of Economic Crisis

Long-Term Care Disparities Conference on the Web

Lung Cancer Treatment For Black and Whites Unequal

Page 1 of 1




Just Posted

NAM Coverage

Civil Liberties

Why There Are Words

Aug 10, 2011