After adjusting for age, race, sex, and concurrent health problems such as diabetes, the risk-adjusted 90-day mortality after AMI was 20.1 percent in hospitals serving no African Americans and 23.7 percent in hospitals with the greatest share of black AMI patients — a 19 percent higher rate. Heart attack patients treated at largely minority-serving hospitals were not sicker and did not have more severe heart attacks than patients at other hospitals, the study showed. In fact, the data show that AMI patients treated in hospitals with no African-American AMI patients were the sickest, as measured by an index of comorbidities, but had the lowest risk-adjusted mortality rates.

The differences in risk-adjusted hospital mortality outcomes also were not explained by patients’ income, type of hospital ownership, the hospitals’ annual AMI patient volume, region of the country, or urban status.

“We suspected that these differences could have been caused by the higher rates of poverty among the elderly African-American population, but this was not the case,” Skinner notes. Moreover, he notes, the differences could not be attributed to the likelihood of the hospital providing certain post-AMI surgical interventions, such as coronary artery bypass grafting.

The researchers point out that in this study, 21 percent of the hospitals treated 69 percent of the elderly African-American AMI patients. The average Medicare AMI patient was treated in a hospital where 6.9 percent of AMI patients were African American. Relative to the hospital where the average AMI patient was treated, hospitals that disproportionately treated African Americans were more likely to be teaching facilities, more likely to be government-run (non-Federal), and less likely to be not-for-profit.

The researchers further suggest that, because many African-American Medicare beneficiaries live in urban areas with more than one hospital, disparities might be reduced by directing patients toward hospitals known to provide high-quality care.

To contact Dr. Richard Suzman: Call Susan Farrer or Vicky Cahan, NIA Office of Communications and Public Liaison, 301-496-1752.

To contact Dr. Jonathan Skinner: Call Deborah Kimbell, Media Relations, Dartmouth Medical School, 603-653-1913.

The NIA is the lead federal agency conducting and supporting basic, biomedical, and behavioral and social research on aging and the special needs and problems of older people. For more information on research and age-related health issues, visit the NIA website at www.nia.nih.gov or call toll free 1-800-438-4380.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.