Abstract 18743: Lack of Evidence of Higher 30-day All-cause Readmission Among Older African American (vs. White) Medicare Beneficiaries Hospitalized for Heart Failure

Abstract

Background: A recent study using administrative data suggested that older African American heart failure (HF) patients may have higher 30-day readmissions than whites do (PMC3332042). However, to what extent these associations are intrinsic remains unclear. Methods: Of the 8042 Medicare beneficiaries hospitalized for HF and discharged alive from 106 U.S. hospitals (1998-2001), 1994 were African American and 6048 were white. Using propensity scores for being an African American, we assembled a matched cohort of 1799 pairs of African American and white patients balanced on 33 baseline characteristics. Results: Matched patients (N=3598) had a mean age of 74 (±11) years with no racial difference (p=0.599). 30-day all-cause readmission occurred in 20% and 22% of matched African Americans and whites, respectively (HR, 0.89; 95% CI, 0.77-1.03; p=0.110; Figure, left panel). In the pre-match cohort (N=8042), African Americans were younger (77 v 72 years for whites; p<0.001) and had similar unadjusted 30-day all-cause readmission (20% v. 20% for whites; p=0.075), but had significantly lower risk when adjusted for age and sex (HR, 0.87; 95% CI, 0.77-0.98; p=0.018; Figure, right panel) but not for propensity scores (HR, 0.90; 95% CI, 0.80-1.02; p=0.101). Among matched patients, race had no association with 30-day HF readmission or all-cause mortality. Conclusions: Findings from our propensity-matched study suggest that in a cohort of hospitalized African American and white HF patients who were balanced on 33 baseline characteristics, race had no independent association with 30-day all-cause or HF readmissions or all-cause mortality.