Racial disparities in patients' death risk after heart bypass surgery are affected by the quality of the hospital in which the surgery is performed, a large new study suggests.
Racial disparities in death rates after bypass surgery are well documented, but less was known about how hospital quality might contribute to these disparities, the researchers said.
They analyzed data from more than 170,000 Medicare patients who had heart bypass surgery. Of those patients, about 9 percent were nonwhite. The researchers found that nonwhite patients had a 33 percent higher death rate after bypass surgery than white patients.
In hospitals with the highest rates of nonwhite patients (more than 17.7 percent), the death rate was 4.8 percent for nonwhite patients and 3.8 percent for white patients, according to the study, which was published online Jan. 8 in the journal JAMA Surgery.
Hospital quality, socioeconomic status and patient factors accounted for 53 percent of the disparity between nonwhite and white patients. The reasons for a large portion of the disparity, however, remain unknown, said study author Dr. Govind Rangrass and colleagues at the University of Michigan.
Having less access to high-quality hospitals with low death rates explains a large portion of racial disparities in death rates following heart bypass surgery, the researchers said. Other factors might include regional variations in hospital quality, how close patients live to high-quality hospitals and race-based referral decisions.
