Racial disparities persist in hospital readmission among young patients with acute MI
Click Here to Manage Email Alerts
Among young acute MI survivors, Black individuals had greater risk for all-cause hospital readmission within 1 year of discharge compared with white individuals, researchers reported in JAMA Network Open.
“These findings show that readmission at 1 year after acute MI disproportionately affects Black individuals, and clinical and psychosocial factors do not explain most of this difference,” Chinenye M. Okafor, MPH, MBBS, administrative fellow at Medical University of South Carolina (MUSC) Health, and colleagues wrote.
Image: Adobe Stock
To determine potential racial differences in all-cause hospital readmission in young adults with acute MI 1 year after discharge, Okafor and colleagues analyzed 2,822 individuals from the VIRGO study aged 18 to 55 years (median age, 48 years; 67.7% women; 18.9% Black) hospitalized with acute MI. Data were analyzed between August and December 2021.
In addition, researchers utilized logistic models to “examine the associations of demographic characteristics, cardiac risk factors, comorbidities and medical history, presentation characteristics, disease severity and social determinants of health with the likelihood of all-cause readmission at 1 year.”
Okafor and colleagues found that the rate of all-cause hospital readmission was higher for Black individuals compared with white individuals (39.4% vs. 28.8%; P < .001), and Black women had the highest rate among subgroups.
In addition, after adjustment for sociodemographic characteristics, cardiac risk factors and social determinants of health, odds of readmission were higher for Black patients than for white patients (OR = 1.34; 95% CI, 1.06-1.68).
Unemployment (OR = 1.68; 95% CI, 1.09-2.59; P for interaction = .02) and fewer number of hours worked per week (OR = 1.01; 95% CI, 1-1.02; P for interaction = .01) both positively moderated the association between Black race and 1-year all-cause hospital readmission.
“Our study broadens the existing evidence by taking into consideration a wide spectrum of social determinants of health under the World Health Organization conceptual framework and highlights that Black participants have a greater burden of nonclinical risk factors compared with white individuals,” Okafor and colleagues wrote.
The authors added that their findings “necessitate further research to explore other unmeasured factors that explain the racial differences in readmission at 1 year, including structural racism and implicit bias, as well as more focus on addressing these upstream influences.”
Collapse
Click Here to Manage Email Alerts