Women with heart disease are less likely than men to receive optimal care at discharge from U.S. hospitals -- a gender disparity that leads to a higher death rate among women with heart disease, according to a study presented at the American Heart Association's Scientific Sessions 2015.
Black patients with heart disease also have a higher death rate after hospital discharge than white patients, but this disparity cannot be explained by the differences in hospitals' quality of care.
Researchers referred to the American Heart Association Get With The Guidelines Coronary Artery Disease (GWTG-CAD) registry linked with Medicare inpatient data. The study included 49,358 Medicare patients hospitalized at 366 U.S. hospitals from 2003 to 2009. They analyzed quality of care (based on how many performance measures hospitals followed for eligible patients) and three-year death rates from any cause after being discharged.
Among the 16,130 deaths identified at the follow-up, researchers found women were less likely to receive optimal care at discharge and, when they received suboptimal care, were 23 percent more likely to die than men. The disparity disappeared when women received optimal care.
While researchers found no difference in care quality across racial and ethnic groups, as well as across geographic regions, they did uncover a 36 percent higher likelihood that blacks would die compared to whites. The disparity remained regardless of the care quality.
The observed disparity in death rate between men and women could be reduced by providing equitable and optimal care. The same does not appear to be true for the disparity that exists between black and white patients, researchers said.
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