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The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study

BACKGROUND: Alcoholic Hepatitis (AH) is major source of alcohol-related mortality and health care expenditures in the United States. There is insufficient information regarding the role of race and ethnicity on healthcare utilization and outcomes for patients with AH. We aimed to determine whether t...

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Autores principales: May, Folasade P., Rolston, Vineet S., Tapper, Elliot B., Lakshmanan, Ashwini, Saab, Sammy, Sundaram, Vinay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5057210/
https://www.ncbi.nlm.nih.gov/pubmed/27724882
http://dx.doi.org/10.1186/s12876-016-0544-y
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author May, Folasade P.
Rolston, Vineet S.
Tapper, Elliot B.
Lakshmanan, Ashwini
Saab, Sammy
Sundaram, Vinay
author_facet May, Folasade P.
Rolston, Vineet S.
Tapper, Elliot B.
Lakshmanan, Ashwini
Saab, Sammy
Sundaram, Vinay
author_sort May, Folasade P.
collection PubMed
description BACKGROUND: Alcoholic Hepatitis (AH) is major source of alcohol-related mortality and health care expenditures in the United States. There is insufficient information regarding the role of race and ethnicity on healthcare utilization and outcomes for patients with AH. We aimed to determine whether there are racial/ethnic differences in resource utilization and inpatient mortality in patients hospitalized with AH. METHODS: We analyzed data from the Nationwide Inpatient Sample (NIS), years 2008–2011. We calculated demographic, clinical, and healthcare utilization characteristics by race. We then performed logistic regression and generalized linear modeling with gamma distribution (log link), respectively, to determine predictors of inpatient morality and total hospital costs (THC). RESULTS: We identified 11,304 AH patients from 2008 to 2011. Mean age was 47.0 years, and 62.1 % were male, 61.9 % were white, 9.8 % were black, and 9.7 % were Hispanic. Mean LOS was 6.3 days and significantly longer in whites (6.5 d) than both blacks (5.4 d) and Hispanics (5.9 d). In adjusted models, inpatient mortality was lower for blacks than for whites (adj. OR = 0.50; 95 % CI = 0.32–0.78). THC was significantly higher for Hispanics than whites (fold increase = 1.25; 95 % CI = 1.01–1.49). CONCLUSIONS: We identified differences in healthcare utilization and mortality by race/ethnicity. THC was significantly higher among Hispanics than for whites and blacks. We also demonstrated lower inpatient mortality in blacks compared to whites. These variations may implicate racial and ethnic differences in access to care, quality of care, severity of AH on presentation, or other factors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-016-0544-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-50572102016-10-20 The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study May, Folasade P. Rolston, Vineet S. Tapper, Elliot B. Lakshmanan, Ashwini Saab, Sammy Sundaram, Vinay BMC Gastroenterol Research Article BACKGROUND: Alcoholic Hepatitis (AH) is major source of alcohol-related mortality and health care expenditures in the United States. There is insufficient information regarding the role of race and ethnicity on healthcare utilization and outcomes for patients with AH. We aimed to determine whether there are racial/ethnic differences in resource utilization and inpatient mortality in patients hospitalized with AH. METHODS: We analyzed data from the Nationwide Inpatient Sample (NIS), years 2008–2011. We calculated demographic, clinical, and healthcare utilization characteristics by race. We then performed logistic regression and generalized linear modeling with gamma distribution (log link), respectively, to determine predictors of inpatient morality and total hospital costs (THC). RESULTS: We identified 11,304 AH patients from 2008 to 2011. Mean age was 47.0 years, and 62.1 % were male, 61.9 % were white, 9.8 % were black, and 9.7 % were Hispanic. Mean LOS was 6.3 days and significantly longer in whites (6.5 d) than both blacks (5.4 d) and Hispanics (5.9 d). In adjusted models, inpatient mortality was lower for blacks than for whites (adj. OR = 0.50; 95 % CI = 0.32–0.78). THC was significantly higher for Hispanics than whites (fold increase = 1.25; 95 % CI = 1.01–1.49). CONCLUSIONS: We identified differences in healthcare utilization and mortality by race/ethnicity. THC was significantly higher among Hispanics than for whites and blacks. We also demonstrated lower inpatient mortality in blacks compared to whites. These variations may implicate racial and ethnic differences in access to care, quality of care, severity of AH on presentation, or other factors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-016-0544-y) contains supplementary material, which is available to authorized users. BioMed Central 2016-10-10 /pmc/articles/PMC5057210/ /pubmed/27724882 http://dx.doi.org/10.1186/s12876-016-0544-y Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
May, Folasade P.
Rolston, Vineet S.
Tapper, Elliot B.
Lakshmanan, Ashwini
Saab, Sammy
Sundaram, Vinay
The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title_full The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title_fullStr The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title_full_unstemmed The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title_short The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
title_sort impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5057210/
https://www.ncbi.nlm.nih.gov/pubmed/27724882
http://dx.doi.org/10.1186/s12876-016-0544-y
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