Relationship Between Hospital Team Segregation Index, Heart Failure, and Ischemic Heart Disease
Adedoyin Johnson1, Shannon M Knapp2, Hunter Mwansa3
1Department of Internal Medicine, Indiana University, Indianapolis, Indiana, USA.
JACC. Advances
|July 19, 2025
Summary
Hospital segregation impacts cardiovascular care for Black patients with ischemic heart disease, affecting readmission and survival rates. Heart failure outcomes showed no significant variation by segregation index.
Area of Science:
- Cardiovascular Medicine
- Health Equity
- Health Services Research
Background:
- Structural racism in cardiovascular care is understudied.
- Understanding disparities in care for Black patients is crucial.
Purpose of the Study:
- To assess the association between hospital segregation index (SI) and care, readmission, and survival for Black vs. White patients with heart failure (HF) or ischemic heart disease (IHD).
Main Methods:
- Analysis of Optum's Clinformatics Data Mart (2010-2018).
- Mixed effects models used to evaluate hospital SI's effect on Black and White patients with HF or IHD.
- Hospitals categorized by SI tertiles.
Main Results:
- For heart failure (HF), Black patients had lower odds of cardiologist care, but readmission and survival did not differ by SI.
- For ischemic heart disease (IHD), Black patients not seen by cardiologists faced higher readmission risk in high SI hospitals.
- Black patients receiving cardiology care in low SI hospitals had higher 1-year survival odds.
Conclusions:
- Hospital segregation did not affect heart failure outcomes by race.
- For ischemic heart disease, segregation index influenced Black patients' readmission risk and survival.
- Targeted interventions may be needed to address racial disparities in IHD care within segregated hospital settings.
Keywords:
cardiovascular outcomescoronary heart diseaseheart failureischemic heart diseaseracial disparitiesMore Related Videos
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