WMJ Vol 120 Supplement 1: Does Racial Disparity Exist Among Inpatient Admissions for Heart Attacks in Wisconsin?

ABSTRACT

Objective: Acute myocardial infarction (AMI), or heart attack, carries a high inpatient death risk. Few national studies suggest race affects the outcomes of inpatients with AMI. In Wisconsin, an assessment of racial disparity among admissions for AMI is lacking.

Methods: Using the Wisconsin State Inpatient Database from 2016, demographics and outcomes for AMI admissions were analyzed. The goal was to compare demographic and hospitalization characteristics between non-Hispanic White patients and Black, Indigenous, and People of Color (BIPOC).

Results: A total of 6,002 non-Hispanic Whites and 546 BIPOC cases were identified. BIPOC were younger than non-Hispanic White inpatients (median age, 59 years vs 68 years, respectively; P < 0.001). Median length of stay was shorter in non-Hispanic White versus BIPOC (2 days vs 3 days; P = 0.021), and mean total charges were higher for BIPOC than non-Hispanic Whites ($74,716 vs $65,384, respectively; P = 0.002). Using a risk-adjusted model, inpatient mortality was increased for patients over 55 years of age (odds ratio [OR] 2.166; 95% CI, 1-3; P = 0.001) and women (OR 1.319; 95% CI, 1-1.6; P = 0.03). Race (BIPOC vs non-Hispanic White) was not predictive of inpatient death on univariable analysis (OR 0.771; 95% CI, 0.4-1.2; P = 0.283).

Conclusion: It appears BIPOC have longer hospital stays and incur higher charges than non-Hispanic White patients, though race does not affect mortality risk. Among Wisconsin counties with higher proportions of AMI, these data may enable strategic recommendation of hospitalized patients or permit risk stratification to identify disparity and encourage equitable care.

Intended Audience

The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.

Learning Objectives

As a result of engaging with this content, members of the healthcare team will be able to:

  1. Explain the racial disparity that may exist among patients admitted for heart attacks.
  2. Show that in Wisconsin, there appears to be no association of race with in-hospital mortality, however BIPOC incur higher costs and have longer inpatient stays for heart attacks compared to non-Hispanic white inpatients.
  3. Make use of data to promote further identification and elimination of inpatient racial bias in Wisconsin, regardless of the admitting diagnosis.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™
Registration opens: 
05/03/2021
Course expires: 
05/02/2022
Cost:
$0.00
Part of: 
Wisconsin Medical Journal Volume 120
Rating: 
0

FACULTY DISCLOSURE

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE).  In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Name of IndividualIndividual's Role in Activity

Name of Commercial Interest &
Nature of Relationship

Discussion of
Unlabeled/Unapproved
Uses of Drugs/Devices
in Presentation?

Terese Bailey, BSAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Ivor Benjamin, MDReviewerNo relevant relationships with ineligible companies to discloseNo
David Dwyer, PhD, RN, NE-BCReviewerNo relevant relationships with ineligible companies to discloseNo
Charles Gusho, BSAuthorNo relevant relationships with ineligible companies to discloseNo
Greer Jordan, MBA, PhD, BSEEReviewerNo relevant relationships with ineligible companies to discloseNo
Sarina Schrager, MD, MSEditorNo relevant relationships with ineligible companies to discloseNo
Jasmine Zapata, MD, MPHReviewerNo relevant relationships with ineligible companies to discloseNo

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

The ACCME does not consider providers of clinical services directly to patients to be commercial interests.

Discloser List CME Internal Report

Accreditation

Accreditation Statement

Jointly Accredited Provider LogoIn support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Credit Designation Statements

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.  

Iowa Board of Nursing accepts ANCC contact hours for nursing continuing education requirements.

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™

Cost:
$0.00
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