Black American stroke patients actually have worse outcomes when they're treated at hospitals that care for large numbers of minority stroke patients, a new study finds.
Researchers saw no such racial disparity at hospitals that treated more white stroke patients. The study was expected to be presented Wednesday at the American Stroke Association annual meeting, in San Francisco. Differences in available resources and in overall quality of care at individual hospitals may explain apparent racial differences in stroke care, the researchers said. "In the adjusted analysis, we found that disparities in care were related more to the hospitals where patients were treated than to race itself," Dr. Lee Schwamm, vice chairman of neurology and director of acute stroke services at Massachusetts General Hospital in Boston, said in a prepared statement. His team reviewed data on stroke patients treated at 656 hospitals participating in the American Stroke Association's Get With the Guidelines - Stroke program. The hospitals were grouped according to the number of black stroke patients they treated. The study found that at hospitals that treated the most black stroke patients (more than 25 percent): - fewer blacks than whites received clot-busting drugs to treat acute ischemic stroke;
- fewer blacks than whites were prescribed blood thinners when they were discharged from the hospital; and
- blacks were less likely than whites to be referred for smoking cessation efforts.
"The important message is that there is a connection between the proportion of patients who are African-American at an individual hospital, and the type of care provided to all patients at those hospitals. This presents an opportunity to begin to look at analyses of disparities in care in a different way," Schwamm said.
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