Hospitalized Black Patients Have Low Survival Rate Following Cardiac Arrest

September 18, 2009 05:00 PM
by Shannon Firth
A new study published in The Journal of the American Medical Association found that black patients are at greater risk of dying from cardiac arrest than white patients while hospitalized.

Exploring Differences in Hospital Treatment

Although black patients received the same amount of shocks and were resuscitated for the same amount of time as white patients, only 25.2 percent of black patients survived after cardiac arrest, compared with 37.4 percent of white patients, reported the Kansas City Star.

Previous research suggested financial and cultural factors are responsible for differences in the medical treatment minorities receive; however, whether these differences were due to unequal treatment by medical staff, limited access due to health care costs or promptness of care was uncertain, according to the Star.

In the broad study, lead researcher Paul Chan of St. Luke’s Hospital in Kansas City, alongside researchers from St. Luke’s, Yale, Duke, the University of Washington and the University of Michigan, observed more than 10,000 patients at nearly 300 hospitals over 8 years, according to Medical News Today.

Researchers eliminated patient access to care as a factor by studying only patients who were already admitted at hospitals. The study’s findings suggest that the primary difference affecting the survival rates of black patients was their choice of hospital, reported the Star.
As Chan told Medical News Today, “These unadjusted survival differences by race were, in large part, attributable to black patients being more likely to receive treatment at hospitals with worse outcomes.” He specifically cited “large, urban teaching institutions.”

According to the Star, however, Chan did suggest that post-resuscitation treatment, and the fact that black patients in intensive care were less likely to have do-not-resuscitate orders than whites—making it likely that more resuscitations were attempted on very ill blacks than very ill whites—could also have affected survival rates.

Additionally, the fact that black patients had a greater number of existing medical issues upon admission than white patients, such as diabetes mellitus, acute stroke, pneumonia and major trauma, could be significant. However, Chan says this difference could only be responsible for about a third of the difference in patient outcome, reported the Star.

In June, Amitabh Chandra, professor at Harvard University’s Kennedy School of Government, spoke before the U.S. Civil Rights Commission about explicit and implicit discrimination, such as stereotyping, by health care providers. He also touched on the “geography of minority healthcare,” meaning differences in where patients receive care.

“[E]ven if we could fully eliminate disparities in the clinical encounter, the healthcare of blacks would improve, but still lag behind that of whites because of differences in the quality of where the two groups receive care,” Chandra said, according to his testimony, which was published on the Kennedy School’s Web site.

Related Topic: Blacks with gender-related cancer more likely to die than whites

According to a study published July 7 on the Journal of the National Cancer Institute (JNCI) Web site, the survival disparity between white and black patients with gender-related cancers may be due to genetic and biological factors, rather than only socioeconomic and cultural factors.

The study, led by Dr. Kathy Albain of Loyola University (Ill.), examined records of 19,457 cancer patients who were tested by the Southwest Oncology Group between 1974 and 2001, and found that blacks with breast cancer, prostate cancer and ovarian cancer were more likely to die than white patients even if they received the same care.

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