title: Racial Differences in Heart Failure Outcomes: Evidence From the Tele-HF Trial (Telemonitoring to Improve Heart Failure Outcomes).
abstract: OBJECTIVE
  The purpose of this study was to determine whether there are racial differences in patient-reported health status as well as mortality and rehospitalization after hospitalization for heart failure (HF).
  
  
  BACKGROUND
  Little is known about whether racial differences exist in patient-reported outcomes after HF hospitalization.
  
  
  METHODS
  We analyzed data from 1,427 patients (636 non-Hispanic African Americans [45%]; 791 non-Hispanic whites [55%]) enrolled in the Tele-HF (Telemonitoring to Improve Heart Failure Outcomes) trial. Health status was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and then at 3 and 6 months. Generalized linear mixed models and propensity score methods were used to adjust for clustering within sites and differences between races.
  
  
  RESULTS
  Although black patients reported better adjusted health status at baseline (black vs. white difference in KCCQ summary scores was 6.22; 95% confidence interval [CI]: 2.98 to 9.46; p < 0.001), after adjusting for patient demographics, comorbidities, clinical laboratory values, and baseline KCCQ score, we detected no significant racial differences in patient-reported health status at 3 months (black vs. white difference in KCCQ score: 2.28; 95% CI: -0.84 to 5.41; p = 0.15) or 6 months (black vs. white difference in KCCQ score: 1.91; 95% CI: -1.31 to 5.13; p = 0.24).
  
  
  CONCLUSIONS
  Compared with white patients, black patients with HF had better patient-reported health status shortly after HF admission but not at 3 or 6 months. Our study failed to show that black patients were disadvantaged with regard to health status after HF hospitalization. (Tele-HF: Yale Heart Failure Telemonitoring Study; NCT00303212).
authors.affiliation: Department of Health Policy, Management and Behavior, School of Public Health, University at Albany-State University of New York, Albany, New York. Electronic address: fqian@albany.edu.
authors.forename: Feng
authors.initials: F
authors.lastname: Qian
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Parzynski
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Sarwat I
authors.initials: SI
authors.lastname: Chaudhry
authors.affiliation: Department of Health Policy, Management and Behavior, School of Public Health, University at Albany-State University of New York, Albany, New York.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
authors.affiliation: Department of Health Policy, Management and Behavior, School of Public Health, University at Albany-State University of New York, Albany, New York.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Shaw
authors.affiliation: Department of Medicine, School of Medicine, University of Missouri at Kansas City, and Mid America Heart and Vascular Institute, Saint Luke's Health System, St. Luke's Mid America Heart Institute, Kansas City, Missouri.
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006333:Heart Failure / Q000208:ethnology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D010359:Patient Readmission / Q000706:statistics & numerical data*; D044465:White People
keywords: heart failure; outcome; patient-reported health status; racial difference