2066. Are There Racial
Differences in Mortality Rates among Patients Receiving Outpatient Care in the
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.
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.