title: Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations.
abstract: BACKGROUND
  The degree to which outcomes following hospitalization for acute heart failure (HF) vary by racial and ethnic groups is poorly characterized. We sought to compare 30-day and 1-year rehospitalization and mortality rates for HF among 4 race/ethnic groups.
  
  
  RESULTS
  Using the Get With The Guidelines-HF registry linked with Medicare data, we compared 30-day and 1-year outcomes between racial/ethnic groups by using a multivariable Cox proportional hazards model adjusting for clinical, hospital, and socioeconomic status characteristics. We analyzed 47 149 Medicare patients aged ≥65 years who had been discharged for HF between 2005 and 2011: there were 39 213 whites (83.2%), 4946 blacks (10.5%), 2347 Hispanics (5.0%), and 643 Asians/Pacific Islanders (1.4%). Relative to whites, blacks and Hispanics had higher 30-day and 1-year unadjusted readmission rates but lower 30-day and 1-year mortality; Asians had similar 30-day readmission rates but lower 1-year mortality. After risk adjustment, blacks had higher 30-day and 1-year CV readmission than whites but modestly lower short- and long-term mortality; Hispanics had higher 30-day and 1-year readmission rates and similar 1-year mortality than whites, while Asians had similar outcomes. When socioeconomic status data were added to the model, the majority of associations persisted, but the difference in 30-day and 1-year readmission rates between white and Hispanic patients became nonsignificant.
  
  
  CONCLUSIONS
  Among Medicare patients hospitalized with HF, short- and long-term readmission rates and mortality differed among the 4 major racial/ethnic populations and persisted even after controlling for clinical, hospital, and socioeconomic status variables.
authors.affiliation: Ronald Reagan-UCLA Medical Center, Los Angeles, CA (R.P.V., G.C.F.).
authors.forename: Rey P
authors.initials: RP
authors.lastname: Vivo
authors.affiliation: Ochsner Heart and Vascular Institute, New Orleans, LA (S.R.K.).
authors.forename: Selim R
authors.initials: SR
authors.lastname: Krim
authors.affiliation: Duke Clinical Research Institute, Durham, NC (L.L., M.N., A.F.H., Z.J.E., E.D.P.).
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.affiliation: Duke Clinical Research Institute, Durham, NC (L.L., M.N., A.F.H., Z.J.E., E.D.P.).
authors.forename: Megan
authors.initials: M
authors.lastname: Neely
authors.affiliation: Duke Clinical Research Institute, Durham, NC (L.L., M.N., A.F.H., Z.J.E., E.D.P.).
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.affiliation: Duke Clinical Research Institute, Durham, NC (L.L., M.N., A.F.H., Z.J.E., E.D.P.).
authors.forename: Zubin J
authors.initials: ZJ
authors.lastname: Eapen
authors.affiliation: Duke Clinical Research Institute, Durham, NC (L.L., M.N., A.F.H., Z.J.E., E.D.P.).
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.affiliation: VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA (P.A.H.).
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL (C.W.Y.).
authors.forename: Clyde W
authors.initials: CW
authors.lastname: Yancy
authors.affiliation: Ronald Reagan-UCLA Medical Center, Los Angeles, CA (R.P.V., G.C.F.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: health policy and outcome research; heart failure; race/ethnicity; rehospitalization