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Treatment and outcomes for congestive heart failure by race/ethnicity in TRICARE

Ann D Bagchi1, Kate Stewart, Catherine McLaughlin

  • 1Mathematica Policy Research, 600 Alexander Park, Princeton, NJ 08540, USA. abagchi@mathematica-mpr.com

Medical Care
|March 23, 2011
PubMed

Insights

Racial and ethnic disparities exist in congestive heart failure (CHF) medication use among TRICARE beneficiaries. However, these treatment differences did not lead to disparities in potentially avoidable hospitalizations for CHF.

Area of Science:

  • Health Services Research
  • Cardiovascular Health
  • Health Equity

Background:

  • Equitable health insurance access can improve chronic disease outcomes and reduce racial/ethnic health disparities.
  • Congestive heart failure (CHF) management is a key area for examining these disparities.

Purpose of the Study:

  • To investigate racial/ethnic disparities in the treatment and outcomes of care for TRICARE beneficiaries diagnosed with CHF.
  • To determine if observed treatment disparities impact potentially avoidable hospitalizations (PAHs).

Main Methods:

  • Retrospective cohort analysis of 2183 TRICARE beneficiaries with CHF (weighted to 115,584).
  • Examined demographic factors, care sources, comorbidities, CHF-related medication use (beta blockers, ACE inhibitors/ARBs), and CHF-related PAHs.

Main Results:

  • African Americans were less likely than whites to receive beta blockers and ACE inhibitors/ARBs post-CHF diagnosis (P<0.0001).
  • Hispanic beneficiaries showed similar pharmacological treatment rates to whites in some cases.
  • No significant racial/ethnic differences were found in the odds of a PAH; age >65 was the strongest predictor.

Conclusions:

  • While racial/ethnic disparities in CHF pharmacological therapy exist among TRICARE beneficiaries, they do not appear to translate into disparities in PAH likelihood.
  • Findings support the hypothesis that equitable access to care can mitigate racial/ethnic health disparities in CHF outcomes.
Abstract

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