Heart failure & cardiomyopathies
Equity in Heart Failure Care: A Get With the Guidelines Analysis of Between- and Within-Hospital Differences in Care by Sex, Race, Ethnicity, and Insurance
Authors' conclusion
HF quality measure performance was equitable for most measures. There were within-hospital differences in angiotensin receptor neprilysin inhibitor and cardiac resynchronization therapy implant/prescription for historically marginalized groups. The magnitude of hospital-specific disparities varied across hospitals.
Study context
- Population
- Patients hospitalised for heart failure (HF) in the Get With the Guidelines-HF registry, 596 hospitals, 2016–2021
- Participants
- 685,227 patients · 596 hospitals
- Exposure
- Quality of HF care by sex, race, ethnicity and insurance, between and within hospitals
- Outcome
- Performance across 7 guideline-based HF quality measures, with and without adjustment for treating hospital
Methodological detailsregistry-based, multicentre (596 hospitals)
- Registry-based
- Multicentre (596 hospitals)
Main finding
As reported in the abstract
Performance significantly lower for women vs men on all 7 measures before adjustment
7 of 7
No significant sex-related differences after patient-level adjustment
4 of 7
Minorities and Medicaid/uninsured had similar or higher adjusted performance vs White and Medicare/privately insured
20 of 25
Observational data: associations, not effects.
Further findings
Hospital-level variation in CRT implant/prescription, Black vs White
- Hospitals with ≥2% lower CRT implant/prescription for Black vs White patients
- 278 (46.6%)
- Hospitals with same or higher CRT implant/prescription for Black patients
- 109 (18.3%)
Original publication
Summarised from the published abstract; every number is checked against it