Not All Heart Failure Patients Get Same Level of Care, Study Finds

Not All Heart Failure Patients Get Same Level of Care, Study Finds

If you are black or Hispanic and you are hospitalized for heart failure, new research suggests you are less likely to be treated in special cardiac care units.

For the study, researchers analyzed data on nearly 2,000 patients treated for heart failure at Brigham and Women's Hospital in Boston for over 10 years.

"These outcomes are both unjust and avoidable, and in no way unique to a single institution," said study co-lead author Dr. Lauren Eberly, who was a resident at Brigham and Women's during the study. She is now a cardiovascular medicine fellow at the University of Pennsylvania.

"We hope that our findings will encourage other institutions to investigate how racial bias influences care decisions at their center as Brigham and Women's Hospital supported our inquiry," Eberly added.

After adjusting for a number of factors, her team found that Hispanic patients were 17% less likely to be admitted to a heart specialty unit, and black patients were 9% less likely.

The study also found that admission to a heart specialty unit was independently associated with a 16% lower rate of hospital readmission within 30 days.

Hospital readmission within a month often predicts worse outcomes in heart failure patients, the researchers explained.

The findings, published Oct. 29 in the journal Circulation: Heart Failure, may help explain long-recognized racial differences in heart failure outcomes, the researchers said.

They also noted that black and Hispanic patients were not under the care of a cardiologist as an outpatient at the time of hospitalization, and having a cardiologist is the strongest predictor of admission to a cardiology unit.

"We recommend that care delivery be designed to prioritize the care of our most marginalized patients. Only then can we start to eliminate inequity," Eberly said in a journal news release.

Source: Circulation: Heart Failure, news release, Oct. 29, 2019.

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