Valvular & structural heart disease
Association Between Clinician Team Segregation, Receipt of Cardiovascular Care and Outcomes in Valvular Heart Diseases
Authors' conclusion
Among an insured population, race was not associated with care by a cardiologist for VHD or survival. Black patients not seen by cardiologists had higher odds of 30-day readmission in low clinician SG.
Study context
- Population
- Adequately insured patients with a primary diagnosis of valvular heart disease (VHD), US commercial and Medicare database, 2010–2018; hospitals categorised into low, medium and high segregation groups (SG) by clinician segregation index (SI)16.1% Black, 83.9% White
- Participants
- 8,649 participants
- Exposure
- Black vs White patients across hospital clinician segregation groups
- Outcome
- Receipt of care by a cardiologist according to patient race, by clinician segregation group
Methodological detailsGeneralized linear mixed effect models
- Generalized linear mixed effect models
Main finding
As reported in the abstract
Care from a cardiologist (Black vs White)
Black vs WhiteAdjusted odds ratio (95% CI)P value
Low SG
0.79(0.58–1.08)
P = 0.14Medium SG
0.86(0.60–1.25)
P = 0.43High SG
1.07(0.68–1.69)
P = 0.76Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| 30-day readmission, Blackvs White, among those seen by a cardiologist, by SGLow SG | 1.05 (0.83–1.31) | P = 0.70 | |
| 30-day readmission, Blackvs White, among those seen by a cardiologist, by SGMedium SG | 1.22 (0.92–1.61) | P = 0.17 | |
| 30-day readmission, Blackvs White, among those seen by a cardiologist, by SGHigh SG | 0.81 (0.57–1.17) | P = 0.27 | |
| 30-day readmission, Blackvs White, among those not seen by a cardiologist, low SGLow SG | 2.74 (1.38–5.43) | P < 0.01 | |
| 0.20.5125Adjusted odds ratio (log scale) |
1-year survival across race, by SG and receipt of cardiologist care
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Race (seen by a cardiologist, Low SG) | 1.13 (0.86–1.48) | P = 0.38 | |
| Race (seen by a cardiologist, Medium SG) | 0.83 (0.59–1.17) | P = 0.29 | |
| Race (seen by a cardiologist, High SG) | 1.01 (0.66–1.52) | P = 0.98 | |
| Race (not seen by a cardiologist, Low SG) | 0.56 (0.23–1.34) | P = 0.19 | |
| Race (not seen by a cardiologist, Medium SG) | 0.81 (0.28–2.37) | P = 0.70 | |
| Race (not seen by a cardiologist, High SG) | 0.63 (0.23–1.74) | P = 0.37 | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Odds of 1-year survival similar across race for all SG irrespective of receipt of care from a cardiologist
Original publication
Association Between Clinician Team Segregation, Receipt of Cardiovascular Care and Outcomes in Valvular Heart Diseases. ESC Heart Fail. Published 17 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →