title: Treatment and outcomes for congestive heart failure by race/ethnicity in TRICARE.
abstract: BACKGROUND
  Equitable access to health insurance coverage may improve outcomes of care for chronic health conditions and mitigate racial/ethnic health disparities. This study examines racial/ethnic disparities in the treatment and outcomes of care for TRICARE beneficiaries with congestive heart failure (CHF).
  
  
  METHODS
  Using a retrospective cohort analysis, we examined demographic characteristics, sources of care, and comorbid conditions for 2183 beneficiaries of the Military Health System's TRICARE program (representing 115,584 beneficiaries after adjusting for survey weights) with CHF. Treatments included use of CHF-related medications, while the outcome of interest was any CHF-related potentially avoidable hospitalizations (PAHs).
  
  
  RESULTS
  While African Americans were less likely than whites to have received beta blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers following a CHF diagnosis (P<0.0001). Hispanics were, in some cases, equally likely as whites to receive pharmacological treatments for CHF. In multivariate models, there were no significant racial/ethnic differences in the odds of a PAH; age greater than 65 was the most significant predictor of a PAH.
  
  
  CONCLUSIONS
  This study suggests that although there are some racial and ethnic disparities in the receipt of pharmacological therapy for CHF among TRICARE beneficiaries, these differences do not translate into disparities in the likelihood of a PAH. The findings support previous research suggesting that equal access to care may mitigate racial/ethnic health disparities.
authors.affiliation: Mathematica Policy Research, 600 Alexander Park, Princeton, NJ 08540, USA. abagchi@mathematica-mpr.com
authors.forename: Ann D
authors.initials: AD
authors.lastname: Bagchi
authors.forename: Kate
authors.initials: K
authors.lastname: Stewart
authors.forename: Catherine
authors.initials: C
authors.lastname: McLaughlin
authors.forename: Patricia
authors.initials: P
authors.lastname: Higgins
authors.forename: Thomas
authors.initials: T
authors.lastname: Croghan
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000188:drug therapy* / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors