Explaining racial disparities in anticoagulation control: results from a study of patients at the Veterans Administration
Authors
Rao, Sowmya R.Reisman, Joel I.
Kressin, Nancy R.
Berlowitz, Dan R.
Ash, Arlene S.
Ozonoff, Al
Miller, Donald R.
Hylek, Elaine M.
Zhao, Shibei
Rose, Adam J.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2015-05-01
Metadata
Show full item recordAbstract
Higher rates of stroke, major hemorrhage, and death among black patients receiving warfarin, compared with white patients, is likely related to poorer anticoagulation control. The research team investigated patient-level and site-level factors that might account for this group difference. A summary measure of anticoagulation control (percent time in therapeutic range [TTR]), patient characteristics, and site-level process of care measures were obtained for 9572 black and 88 481 white patients at the Veterans Health Administration. The research team studied disparity in TTR adjusting for patient and site characteristics. Mean unadjusted TTR for black patients was 6.5% lower than for white patients (P < .001). After accounting for the younger age of blacks, greater degrees of medication use, hospitalization, poverty, living in the South, and 11 other patient characteristics, only 2.0% of this racial disparity persisted. Process of care measures had minimal additional effect. These findings may inform efforts to reduce this racial disparity in achieving good anticoagulation control.Source
Am J Med Qual. 2015 May;30(3):214-22. doi: 10.1177/1062860614526282. Epub 2014 Mar 18. Link to article on publisher's siteDOI
10.1177/1062860614526282Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30433PubMed ID
24642366Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1177/1062860614526282