Racial Disparities Observed in Stroke Quality of Care

African-Americans tend to receive less evidence-based care than Hispanics or Caucasians
By Rick Ansorge
HealthDay Reporter

FRIDAY, March 26 (HealthDay News) -- African-American ischemic stroke patients have a moderate but consistent reduction in the frequency with which guideline-based care is provided in-hospital, according to a study published online March 22 in Circulation.

Lee H. Schwamm, M.D., of Massachusetts General Hospital in Boston, and colleagues analyzed in-hospital mortality and seven stroke performance measures among 397,257 patients admitted in 2003 to 2008 to 1,181 hospitals participating in the Get With The Guidelines-Stroke program.

The researchers' adjusted analysis showed that in-hospital mortality and care on all seven stroke performance measures were similar among Hispanic and Caucasian patients. Compared to Caucasians, they found that African-Americans were less likely to receive intravenous thrombolysis, deep vein thrombosis prophylaxis, smoking cessation, discharge antithrombotics, anticoagulants for atrial fibrillation, or lipid therapy (odds ratios, 0.84, 0.88, 0.85, 0.88, 0.84, and 0.91, respectively). African-Americans, however, were also less likely to die in hospital (odds ratio, 0.90).

"Our findings contrast with some previous reports of substantially poorer quality of care for black patients with ischemic stroke; however, our findings are consistent with previous reports showing that Hispanic patients received quality of care comparable to that of white patients," the authors conclude. "Substantial improvements in care quality were observed over time in the Get With The Guidelines-Stroke program for each racial/ethnic group."

The Get With The Guidelines-Stroke program receives unrestricted funding from Pfizer and Merck-Schering Plough through the American Heart Association. Two authors reported financial relationships with pharmaceutical companies.

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