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Black patients have better outcomes for common GI diagnoses at racially diverse hospitals
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Black patients with five common gastrointestinal diagnoses had fewer major complications and lower mortality rates when they received treatment at hospitals with greater inpatient racial diversity, according to data published in American Journal of Gastroenterology.
“Our results provide evidence that the lack of inpatient racial diversity may negatively affect outcomes in African American patients, and also influence hospital charges,” the researchers wrote.
Researchers used the 2012 National Inpatient Sample database to determine if there was an association between outcomes for black patients with five different GI diagnoses — cirrhosis and alcoholic hepatitis, inflammatory bowel disease, GI hemorrhage, GI obstruction and laparoscopic cholecystectomy — and the racial diversity of patients in U.S. hospitals. To define diversity, the researchers calculated the proportion of black patients discharged from each hospital using the database, adjusting for patient and hospital control variables.
There were 3,392 hospitals with 848,395 discharges evaluated. On average across all hospitals, the patient population was 27% minority with 14% of those being black.
Higher rates of major complications or death were found overall in the black patients with a GI diagnosis, compared to the white patients (adjusted OR = 1.19; 95% CI; 1.16–1.23). However, significantly lower rates of major complications or mortality were found in black patients when they were treated in hospitals with more racially diverse inpatient populations (aOR = 0.8; 95% CI, 0.74–0.86).
“Our results also demonstrated that when African American patients were treated at hospitals that saw a higher proportion of African American patients, the adjusted odds of having high total charges for the diagnoses studied significantly decreased (aOR = 0.49; 95% CI, 0.46–0.52), from when race was held constant (aOR = 1.36; 95% CI, 1.33–1.39),” the researchers wrote.
They concluded, “While we encourage further exploration of our hypothesis in large, prospective, multicenter studies across the United States, our results highlight the immediate need for continued efforts including the promotion of diversity and minority recruitment initiatives among medical students, physicians, and allied staff that would enrich the patient experience by increasing race-concordant provider–patient interactions; the establishment of benchmarks to standardize the care process; the promotion of cultural competency; and recognition and reduction of implicit biases among providers.” – by Suzanne Reist
Disclosures: The researchers report no relevant financial disclosures.
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