2066. Are There Racial Differences in Mortality Rates among Patients Receiving Outpatient Care in the VA?
AJ Selim, Center for Health Quality, Outcomes and Economic Research (CHQOER), GFincke, CHQOER, Z Cong, CHQOER, D Berlowitz, CHQOER, S Ren, CHQOER, D Miller, CHQOER, A Rosen, CHQOER, A Lee, CHQOER, L Kazis, CHQOER

Objectives: We examined whether racial differences in mortality rates exist among patients receiving outpatient care within the Veterans Health Administration, an equal-access health care system.

Methods: This study used data from the National Survey of Ambulatory Care Patients 1998-99, a prospective monitoring system of outcomes of patients receiving ambulatory care in the Veterans Affairs (VA) integrated service networks. It followed 31,823 ambulatory patients for 18 months. The outcome measure is 18-month mortality rates.

Results: African-Americans had significantly lower actual mortality rates than whites (4.0% vs. 5.2%, p = 0.006). Age-adjusted mortality rates remained lower among African-Americans than whites (4.6% vs. 5.1%), but the differences were no longer statically significant (p=0.406). After controlling for case-mix (sociodemographics, comorbidity, and functional status), the mortality rates became the same for African-Americans and whites (5.1 % vs. 5.1%).

Conclusions: The lack of racial differences in mortality in patients receiving ambulatory care in VHA is reassuring. This warrants further research to determine whether efforts to improve access in other settings will reduce racial disparities in health care.

Impact: Health care delivery systems such as the Veterans Health Administration that offer equal access to ambulatory care may hold promise for preventing and correcting racial disparities that exist in our health care system as a whole.