Racial Disparities Persist in Hospital Stroke Care

MONDAY March 22, 2010 -- Many black patients may not receive the same quality of stroke care in hospitals as white and Hispanic patients do, the results of a U.S. study suggest.

In the study, the researchers analyzed data from 1,181 hospitals participating in the American Heart Association/Americans Stroke Association's Get With The Guidelines-Stroke quality improvement program between 2003 and 2008.

The study focused on 397,257 patients, average age 71, with ischemic stroke, which is the most common type of stroke and is caused by decreased blood flow to the brain. The study findings were published online March 22 in the journal Circulation.

Hispanic and white patients received similar levels of care, the study authors found, but black patients were less likely to receive most of the seven quality measures that are considered "evidence-based" stroke care.

The findings showed that black stroke patients were:

  • 16 percent less likely than whites to receive the clot-busting drug known as tPA and to receive anticoagulants for atrial fibrillation.
  • 12 percent less likely than whites to get preventive treatment for deep vein thrombosis and to be given anti-clotting medications at discharge.
  • 3 percent less likely than whites to receive early anti-clotting medications, and 9 percent less likely to receive cholesterol-lowering therapy.
  • 15 percent less likely than whites to receive smoking cessation counseling.
  • 10 percent less likely than whites to receive "defect-free care," which is defined as the proportion of patients who were given all eligible interventions.

"An interesting finding is that, despite being less likely to receive the interventions, black patients were less likely to die in the hospital than whites or Hispanics," study lead author Dr. Lee H. Schwamm, director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston, said in a news release from the American Heart Association. "We suspect that's because black patients are more likely to have stroke at younger ages and present with less severe strokes than the other groups."

Schwamm said researchers need to "identify the causes of these differences in care among ethnic groups so we can develop strategies to eliminate that small but persistent disparity."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.

Posted: March 2010


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