Black Patients Have Slower Transfer for Revascularization

Black patients have a significantly slower transfer time to a revascularization hospital after AMI

THURSDAY, June 30 (HealthDay News) -- Black patients who have an acute myocardial infarction (AMI) and present to a nonrevascularization hospital are transferred more slowly to revascularization hospitals than their white counterparts, according to a study published in the July issue of Medical Care.

Colin R. Cooke, M.D., from the University of Michigan in Ann Arbor, and colleagues investigated whether the timeliness of hospital transfer and quality of destination hospitals are different between black and white Medicare beneficiaries admitted with AMI. The study included 25,947 white and 2,345 black patients admitted to 857 urban and 774 rural nonrevascularization hospitals in 2006 who were transferred to 928 revascularization hospitals. The length of stay before transfer and the 30-day risk-standardized mortality rate for AMI at the transfer destination were compared for black and white patients.

The investigators found that the mean length of stay before transfer was significantly longer for black than white patients (two days versus one day). Black patients were transferred more slowly, even after adjusting for confounding variables. For every 20 percent increase in the proportion of AMI patients who were black in urban hospitals, the length of stay before transfer for all patients increased by 0.37 days, although this was attenuated in rural hospitals. There was no difference for black or white patients in the risk-standardized mortality rate of the revascularization hospital.

"Black patients who present to nonrevascularization hospitals with AMI are transferred to revascularization hospitals more slowly than white patients," the authors write.

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