Higher 1-year COPD mortality after hospitalisation for White patients

A registry study using US Medicare and Medicaid records revealed that among patients hospitalised for chronic obstructive pulmonary disease (COPD), non-Hispanic White patients had the worst 1-year mortality rates.

Disparities in outcomes and processes of care are affected by race, geography (rural/urban), and socio-economic disadvantage (individual and neighbourhood). Dr Snigdha Jain (Yale School of Medicine, CT, USA) and colleagues sought to examine racial differences in long-term mortality after COPD hospitalisation in a universal, non-integrated healthcare system [1]. In addition, they wanted to determine whether differences could be attributable to geographic characteristics, receipt of post-acute care, or socio-economic characteristics.

Medicare records were screened for patients with a principal diagnosis of COPD or acute respiratory failure with a secondary diagnosis of COPD (n=244,624). The overall cohort was stratified into non-Hispanic White (n=209,208; 85.6%), non-Hispanic Black (n=19,887; 8.1%), Hispanic (n=10,264; 4.2%), or other (n=5,165; 2.1%). Unadjusted survival after 1 year of hospitalisation indicated that non-Hispanic Black patients had a 23% reduced risk of mortality compared with non-Hispanic White patients (HR 0.77; 95% CI 0.74–0.79). Adding geographic and socioeconomic characteristics did not mitigate this result (HR 0.78; 95% CI 0.76–0.80).

Dr Jain concluded that non-Hispanic White Medicare beneficiaries are at greater risk for mortality in the year following COPD hospitalisation compared with those of other race and ethnicity groups, even after accounting for rural or urban residence, as well as individual and neighbourhood socio-economic status.

1. Jain S, et al. Association Between Race, Geography, and 1-Year Mortality After Hospitalization for Chronic Obstructive Pulmonary Disease. Session A93, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.

 

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Posted on 18 July 2022