Racial Disparities Reduced in Quality Monitoring Program

Participating hospitals showed improvements in adherence to evidence-based AMI guidelines
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, May 18 (HealthDay News) -- Hospitals enrolled in a national quality monitoring and improvement program showed improvements in adherence to evidence-based guidelines for acute myocardial infarction (AMI), as well as reductions or elimination of racial/ethnic care disparities, according to research published May 17 in the journal Circulation.

Mauricio G. Cohen, M.D., of the University of Miami Miller School of Medicine, and colleagues conducted an analysis of over 142,593 AMI patients at 443 hospitals participating in the Get With the Guidelines -- Coronary Artery Disease program between 2002 and 2007. They defined as "defect-free care" the proportion of patients that received all eligible performance measures.

The researchers found that defect-free care for the overall study period was 80.9 percent for white patients, 79.5 percent for Hispanics and 77.7 percent for black patients. When analyzed temporally by calendar quarter, there was a significant gap in defect-free care for black patients in the first half of the study. Defect-free care progressively improved for all racial/ethnic groups over the time period studied.

"Will achieving 100 percent defect-free care in all patients also eliminate disparities in clinical outcomes, or do we need specific initiatives targeted at contributors or sub-populations to move toward the true elimination of health disparities?" writes the author of an accompanying editorial. "The question will not be easy to answer and may require complementary contributions from both approaches. Perhaps we need future studies that employ rigorous designs, such as trials that compare compelling targeted (multi-level and multi-factorial), generalized, or combined approaches."

This study was supported in part through an unrestricted education grant from Merck-Schering Plough Partnership. Some study authors disclosed financial ties to Merck-Schering Plough and/or other pharmaceutical and medical device companies.

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