African Americans have better outcomes for five common gastrointestinal diagnoses in hospitals with more racially diverse patients

Philip N. Okafor, Derrick J. Stobaugh, Michelle van Ryn, Jayant A. Talwalkar

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES:We sought to characterize the relationship between hospital inpatient racial diversity and outcomes for African-American patients including rates of major complications or mortality during hospitalization for five common gastrointestinal diagnoses.METHODS:Using the 2012 National Inpatient Sample database, hospital inpatient racial diversity was defined as the percentage of African-American patients discharged from each hospital. Logistic regression was used to predict major complication rates or death, long length of stay, and high total charges. Control variables included age, gender, payer type, patient location, area-associated income quartile, hospital characteristics including size, urban vs. rural, teaching vs. nonteaching, region, and the interaction of the percentage of African Americans with patient race.RESULTS:There were 848,395 discharges across 3,392 hospitals. The patient population was on average 27% minority (s.d.±21%) with African Americans accounting for 14% of all patients. Overall, African-American patients had higher rates of major complications or death relative to white patients (adjusted odds ratio (aOR) 1.19; 95% confidence interval (CI) 1.16-1.23). However, when treated in hospitals with higher patient racial diversity, African-American patients experienced significantly lower rates of major complications or mortality (aOR 0.80; 95% CI 0.74-0.86).CONCLUSIONS:African Americans have better outcomes for five common gastrointestinal diagnoses when treated in hospitals with higher inpatient racial diversity. This has major ramifications on total hospital charges.

Original languageEnglish (US)
Pages (from-to)649-657
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume111
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

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African Americans
Inpatients
Mortality
Odds Ratio
Confidence Intervals
Hospital Charges
Length of Stay
Teaching
Hospitalization
Logistic Models
Databases

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

African Americans have better outcomes for five common gastrointestinal diagnoses in hospitals with more racially diverse patients. / Okafor, Philip N.; Stobaugh, Derrick J.; van Ryn, Michelle; Talwalkar, Jayant A.

In: American Journal of Gastroenterology, Vol. 111, No. 5, 01.05.2016, p. 649-657.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES:We sought to characterize the relationship between hospital inpatient racial diversity and outcomes for African-American patients including rates of major complications or mortality during hospitalization for five common gastrointestinal diagnoses.METHODS:Using the 2012 National Inpatient Sample database, hospital inpatient racial diversity was defined as the percentage of African-American patients discharged from each hospital. Logistic regression was used to predict major complication rates or death, long length of stay, and high total charges. Control variables included age, gender, payer type, patient location, area-associated income quartile, hospital characteristics including size, urban vs. rural, teaching vs. nonteaching, region, and the interaction of the percentage of African Americans with patient race.RESULTS:There were 848,395 discharges across 3,392 hospitals. The patient population was on average 27{\%} minority (s.d.±21{\%}) with African Americans accounting for 14{\%} of all patients. Overall, African-American patients had higher rates of major complications or death relative to white patients (adjusted odds ratio (aOR) 1.19; 95{\%} confidence interval (CI) 1.16-1.23). However, when treated in hospitals with higher patient racial diversity, African-American patients experienced significantly lower rates of major complications or mortality (aOR 0.80; 95{\%} CI 0.74-0.86).CONCLUSIONS:African Americans have better outcomes for five common gastrointestinal diagnoses when treated in hospitals with higher inpatient racial diversity. This has major ramifications on total hospital charges.",
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