Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis
Abstract Background Racial disparities have been reported in liver transplantation and chronic hepatitis C treatment outcomes. Determining causes of these disparities is important given the racially diverse American population and the economic burden associated with chronic liver disease. Methods A...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01392-y |
| _version_ | 1819085017045794816 |
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| author | Ted Spiewak Amir Taefi Shruti Patel Chin-Shang Li Eric Chak |
| author_facet | Ted Spiewak Amir Taefi Shruti Patel Chin-Shang Li Eric Chak |
| author_sort | Ted Spiewak |
| collection | DOAJ |
| description | Abstract Background Racial disparities have been reported in liver transplantation and chronic hepatitis C treatment outcomes. Determining causes of these disparities is important given the racially diverse American population and the economic burden associated with chronic liver disease. Methods A retrospective study was performed among 463 patients diagnosed with cirrhosis admitted from (January 1, 2013 to January 1, 2018) to a tertiary care academic medical center. Patients were identified based on the International Classification of Diseases (ICD-10) for cirrhosis or its complications. Demographic information, laboratory data, medical comorbidities, insurance and adherence to cirrhosis quality care indicators were recorded to determine their relationship to readmission rates and other healthcare outcomes. Results A total of 463 individual patients with cirrhosis were identified including Whites (n = 241), Hispanics (n = 106), Blacks (n = 50), Asian and Pacific Islander Americans (API, n = 27) and Other (n = 39). A significantly higher proportion of Blacks had Medicaid insurance compared to Whites (40% versus 20%, p = 0.0002) and Blacks had lower median income than Whites ($45,710 versus $54,844, p = 0.01). All groups received high quality cirrhosis care. Regarding healthcare outcomes, Black patients had the highest mean total hospital admissions (6.1 ± 6.3, p = 0.01) and the highest mean number of 30-day re-admissions (2.1 ± 3.7, p = 0.05) compared to all other racial groups. Multivariable proportional odds regression analysis showed that race was a statistically significant predictor of 90-day readmission (p = 0.03). Conclusions Black Americans hospitalized for complications of cirrhosis may experience significant disparities in healthcare outcomes compared to Whites despite high quality cirrhosis care. Socioeconomic factors may contribute to these disparities. |
| first_indexed | 2024-12-21T20:57:40Z |
| format | Article |
| id | doaj.art-e9cd448f717e4c0982bd339b5d163230 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-21T20:57:40Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-e9cd448f717e4c0982bd339b5d1632302022-12-21T18:50:32ZengBMCBMC Gastroenterology1471-230X2020-07-012011810.1186/s12876-020-01392-yRacial disparities of Black Americans hospitalized for decompensated liver cirrhosisTed Spiewak0Amir Taefi1Shruti Patel2Chin-Shang Li3Eric Chak4Department of Internal Medicine, UC Davis Medical CenterDepartment of Gastroenterology and Hepatology, UC Davis Medical CenterDepartment of Internal Medicine, UC Davis Medical CenterSchool of Nursing, The State University of New York at BuffaloDepartment of Gastroenterology and Hepatology, UC Davis Medical CenterAbstract Background Racial disparities have been reported in liver transplantation and chronic hepatitis C treatment outcomes. Determining causes of these disparities is important given the racially diverse American population and the economic burden associated with chronic liver disease. Methods A retrospective study was performed among 463 patients diagnosed with cirrhosis admitted from (January 1, 2013 to January 1, 2018) to a tertiary care academic medical center. Patients were identified based on the International Classification of Diseases (ICD-10) for cirrhosis or its complications. Demographic information, laboratory data, medical comorbidities, insurance and adherence to cirrhosis quality care indicators were recorded to determine their relationship to readmission rates and other healthcare outcomes. Results A total of 463 individual patients with cirrhosis were identified including Whites (n = 241), Hispanics (n = 106), Blacks (n = 50), Asian and Pacific Islander Americans (API, n = 27) and Other (n = 39). A significantly higher proportion of Blacks had Medicaid insurance compared to Whites (40% versus 20%, p = 0.0002) and Blacks had lower median income than Whites ($45,710 versus $54,844, p = 0.01). All groups received high quality cirrhosis care. Regarding healthcare outcomes, Black patients had the highest mean total hospital admissions (6.1 ± 6.3, p = 0.01) and the highest mean number of 30-day re-admissions (2.1 ± 3.7, p = 0.05) compared to all other racial groups. Multivariable proportional odds regression analysis showed that race was a statistically significant predictor of 90-day readmission (p = 0.03). Conclusions Black Americans hospitalized for complications of cirrhosis may experience significant disparities in healthcare outcomes compared to Whites despite high quality cirrhosis care. Socioeconomic factors may contribute to these disparities.http://link.springer.com/article/10.1186/s12876-020-01392-yAfrican AmericansLiver cirrhosisHealth care disparities |
| spellingShingle | Ted Spiewak Amir Taefi Shruti Patel Chin-Shang Li Eric Chak Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis BMC Gastroenterology African Americans Liver cirrhosis Health care disparities |
| title | Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis |
| title_full | Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis |
| title_fullStr | Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis |
| title_full_unstemmed | Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis |
| title_short | Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis |
| title_sort | racial disparities of black americans hospitalized for decompensated liver cirrhosis |
| topic | African Americans Liver cirrhosis Health care disparities |
| url | http://link.springer.com/article/10.1186/s12876-020-01392-y |
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