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New AHCPR-Supported Study Reported in Archives of Internal Medicine
Press Release Date: August 7, 1995
A RAND study supported by the Agency for Health Care Policy and
Research in cooperation
with the Department of Veterans Affairs, and published in the
August 7/21 issue of Archives of
Internal Medicine, concludes that racial factors do not
appear to be an important determinant of
the intensity of diagnostic or therapeutic care among patients
who are hospitalized with
Pneumocystis carinii pneumonia (PCP). In a report
entitled, "Racial Differences in Care Among
Hospitalized Patients with Pneumocystis Carinii Pneumonia
in Chicago, New York, Los Angeles,
Miami, and Raleigh-Durham," researchers found that variations in
care are largely attributable to
differences in health insurance and admitting hospital
characteristics.
While strategies for medical care for human immunodeficiency
virus-related PCP are well
established, this study is the first to evaluate racial variation
in care.
Researchers performed a retrospective review of charts of a
cohort of 627 Veterans
Administration (VA) patients and 1,547 non-VA patients with
empirically treated or cytologically
confirmed PCP who were hospitalized from 1987 to 1990. Outcomes
included representative
aspects of the process of care for PCP and short-term mortality
rates.
Among VA patients, it was determined that black and Hispanic
patients were not significantly
different from white patients with regard to in-hospital
mortality rates, use and timing of a
bronchoscopy, or receipt of timely anti-PCP medications. Among
non-VA patients, black and
Hispanic patients were more likely to die in the hospital and
less likely to undergo a diagnostic
bronchoscopy in the first 2 days of hospitalization. Racial and
ethnic group differences in the use
of bronchoscopy and in-hospital mortality among non-VA patients
were almost fully accounted
for by differences in health insurance status and hospital
characteristics.
Note: For details, refer to Bennett CL, Horner RD, Weinstein RA,
et al. Racial Differences in
Care Among Hospitalized Patients with Pneumocystis carinii Pneumonia in Chicago, New York,
Los Angeles, Miami, and Raleigh-Durham. Archives of Internal
Medicine, 155(15):1586-1592;
August 7/21, 1995.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.
5600 Fishers Lane Rockville, MD 20857