| Title |
Race, resource use, and survival in seriously III hospitalized adults
|
|---|---|
| Published in |
Journal of General Internal Medicine, July 1996
|
| DOI | 10.1007/bf02600183 |
| Pubmed ID | |
| Authors |
Russell S. Phillips, Mary Beth Hamel, Joan M. Teno, Paul Bellamy, Steven K. Broste, Robert M. Califf, Humberto Vidaillet, Roger B. Davis, Lawrence H. Muhlbaier, Alfred F. Connors, Joanne Lynn, Lee Goldman, the SUPPORT Investigators |
| Abstract |
To examine the association between patient race and hospital resource use. Prospective cohort study. Five geographically diverse teaching hospitals. Patients were 9,105 hospitalized adults with one of nine illnesses associated with an average 6-month mortality of 50%. Measures of resource use included: a modified version of the Therapeutic Intervention Scoring System (TISS); performance of any of five procedures (operation, dialysis, pulmonary artery catheterization, endoscopy, and bronchoscopy); and hospital charges, adjusted by the Medicare cost-to-charge ratio per cost center at each participating hospital. The median patient age was 65; 79% were white, 16% African-American, 3% Hispanic, and 2% other races; 47% died within 6 months. After adjusting for other sociodemographic factors, severity of illness, functional status, and study site, African-Americans were less likely to receive any of five procedures on study day 1 and 3 (adjusted odds ratio [OR] 0.70; 95% confidence interval [CI] 0.60, 0.81). In addition, African-Americans had lower TISS scores on study day 1 and 3 (OR -1.8; 95% CI-1.3, -2.4) and lower estimated costs of hospitalization (OR (-)$2,805; 95% CI (-)$1,672, (-)$3,883). Results were similar after adjustment for patients' preferences and physicians' prognostic estimates. Differences in resource use were less marked after adjusting for the specialty of the attending physician but remained significant. In a subset analysis, cardiologists were less likely to care for African-Americans with congestive heart failure (p < .001), and cardiologists used more resources (p < .001). After adjustment for other sociodemographic factors, severity of illness, functional status, and study site, survival was slightly better for African-American patients (hazard ratio 0.91; 95% CI 0.84, 0.98) than for white or other race patients. Seriously ill African-Americans received less resource-intensive care than other patients after adjustment for other sociodemographic factors and for severity of illness. Some of these differences may be due to differential use of subspecialists. The observed differences in resource use were not associated with a survival advantage for white or other race patients. |
Mendeley readers
The data shown below were compiled from readership statistics for 7 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 7 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 57% |
| Student > Bachelor | 1 | 14% |
| Other | 1 | 14% |
| Student > Doctoral Student | 1 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 5 | 71% |
| Economics, Econometrics and Finance | 1 | 14% |
| Unknown | 1 | 14% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2003.
All research outputs
#7,943,894
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#4,251
of 7,806 outputs
Outputs of similar age
#8,647
of 30,024 outputs
Outputs of similar age from Journal of General Internal Medicine
#6
of 11 outputs
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