Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Racial differences in quality of care and outcome among patients with AIDS-related Pneumocystis carinii pneumonia (PCP) (Meeting abstract).
Proc Annu Meet Am Soc Clin Oncol; 13:A9 1994. Unique Identifier : AIDSLINE ICDB/94600006 Cassileth B; Bennett CL; Bastian L; Duke Univ., Durham NC
Abstract:
Blacks and Hispanics with AIDS have poorer prognoses, although the primary causes are unknown. Medical records of 980 admissions to 55 hospitals in Los Angeles, Miami, and Chicago for AIDS-related PCP, the most common opportunistic infection, were reviewed. Factors associated with higher rates of in-hospital mortality were: being black (21%) or Hispanic (21%) vs being white (11%), not having private health insurance, and not having a bronchoscopy performed and/or anti-PCP medication initiated in the first two days of hospitalization (all p less than 0.05). Racial differences in death rates were confined primarily to the least severely ill: ie A-a O2 gradient less than 45 mm Hg (relative risk compared with whites, 2.8 for blacks and 2.3 for Hispanics, p less than 0.05). Among this group (n=603), care differed in the first two days: blacks were less likely to have a bronchoscopy (14% of blacks vs 26% of Hispanics and 28% of whites, p less than 0.05) and Hispanics were less likely to have anti-PCP medication initiated (68% for Hispanics vs 80% for blacks and 78% for whites, p less than 0.05). After adjusting for severity of illness, prior AIDS diagnosis, HIV risk group, payer, prior use of AZT and PCP prophylaxis, use of bronchoscopy and anti-PCP medications in the first two days of hospitalization, and hospital characteristics, blacks were still 68% more likely and Hispanics 67% more likely to die in the hospital than whites (p less than 0.05). Differences in care, at least in part, explain the poorer prognoses found for black and Hispanic patients.
Keywords: AIDS-Related Opportunistic Infections/ETHNOLOGY/*MORTALITY/ THERAPY Comparative Study *Cross-Cultural Comparison *Hispanic Americans Hospital Mortality Human *Negroid Race Pneumonia, Pneumocystis carinii/ETHNOLOGY/*MORTALITY/THERAPY Prognosis *Quality Assurance, Health Care Risk Factors United States/EPIDEMIOLOGY ABSTRACT 940830
M9480791
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
