Factors Underlying Racial Disparities in Hospital Care of Congestive Heart Failure

OBJECTIVE: To examine relationships between race and five aspects of hospital care. METHODS: Cross-sectional data of 373,158 discharges with heart failure in the 1995-1997 National Inpatient Sample were used to measure severity, care-seeking patterns, processes, resource consumption, and outcomes. RESULTS: Compared to White patients, African American and Hispanic patients were more likely to seek care through the emergency department (ED) but less likely to receive clinical procedures or die in the hospital. Interactions of African American race with patient co-morbidity status, admission through the ED, and receipt of intensive services were associated with lower mortality as was interaction between admission to teaching hospitals and Hispanic race. CONCLUSIONS: Lack of access to ambulatory care among minority patients and hospital care via the safety net may contribute to racial discrepancies as a result of healthier patient selection among minority groups