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However, our study suggests that racial disparities may be as much about the system in which black patients get their care as about patient- or physician-level factors. Selective referral, moving high risk surgical patients at hospitals with high mortality rates to other centers with better outcomes, is one obvious but likely impractical approach to addressing potential problems at hospitals that disproportionately treat black patients. Large numbers of patients would be involved and their access to low mortality rate centers (even if they could be readily identified) is uncertain. Moreover, removing surgical caseloads from hospitals that disproportionately treat black patients might worsen care for other patients by further eroding resources at those centers.
Black patients had higher crude mortality rates than white patients for 7 of the 8 operations, including coronary artery bypass, aortic valve replacement, abdominal aortic aneurysm repair, carotid endarterectomy, radical cystectomy, pancreatic resection, and esophagectomy. Among these 7 procedures, odds ratios of mortality (black versus white) ranged from 1.23 (95% confidence interval, 1.18–1.29) for CABG to 1.61 (95% confidence interval, 1.28–2.03) for esophagectomy. Adjusting for patient characteristics had modest or no effect on odds ratios of mortality by race. However, there remained few clinically or statistically significant differences in mortality by race after we accounted for hospital. Hospitals that treated a large proportion of black patients had higher mortality rates for all 8 procedures, for white as well as black patients.
Among Medicare beneficiaries, black patients were more likely to be readmitted after hospitalization for surgical procedures. Since racial disparities in readmission rates are mediated both by patients' race and the hospital at which care is delivered, efforts at reducing disparities should focus not only on race-based measures but also on improving outcomes of care at minority-serving hospitals.
originally posted by: olaru12
a reply to: Vasa Croe
Perhaps it has to do with intentions. I honestly think that the medical establishment wants to help people.
Law enforcement on the other hand seems to have a "we/them" mindset and that leads to conflict.
Numbers and research don't lie! I feel that the "I Can't Breathe" and "Black Lives Matter" slogans are a bit more appropriate to this discussion.
originally posted by: olaru12
a reply to: Vasa Croe
Perhaps it has to do with intentions. I honestly think that the medical establishment wants to help people.
Law enforcement on the other hand seems to have a "we/them" mindset and that leads to conflict.
originally posted by: InverseLookingGlass
a reply to: Vasa Croe
Numbers and research don't lie! I feel that the "I Can't Breathe" and "Black Lives Matter" slogans are a bit more appropriate to this discussion.
Let's clarify this shall we? Your assertion is that racial skews in the mortality in health care outcomes is a more outrageous scenario than murder by State operatives? It's more outrageous, therefore is is more worthy of civil liberties protester's time.
You would be doing ATS a service if, instead of putting out this rubbish you would openly explore the elements you are substituting for logic, reason and human empathy.
originally posted by: Vasa Croe
Had you bothered to read the articles, they are specifically Medicare related, which IS government funded state operatives. And yes, more blacks are dying from the same procedures than whites in this system by a fairly large gap.
.
originally posted by: olaru12
originally posted by: Vasa Croe
Had you bothered to read the articles, they are specifically Medicare related, which IS government funded state operatives. And yes, more blacks are dying from the same procedures than whites in this system by a fairly large gap.
.
I think you know as well as I do that it's environmental poverty, lack of pre natal care, lack of education, lack of access, no insurance, substance abuse, that is the cause of more blacks dying in the medical system.
It's really transparent what you are trying to do here.
originally posted by: olaru12
originally posted by: Vasa Croe
Had you bothered to read the articles, they are specifically Medicare related, which IS government funded state operatives. And yes, more blacks are dying from the same procedures than whites in this system by a fairly large gap.
.
I think you know as well as I do that it's environmental poverty, lack of pre natal care, lack of education, lack of access, no insurance, substance abuse, that is the cause of more blacks dying in the medical system.
It's really transparent what you are trying to do here.
originally posted by: Vasa Croe
originally posted by: olaru12
originally posted by: Vasa Croe
Had you bothered to read the articles, they are specifically Medicare related, which IS government funded state operatives. And yes, more blacks are dying from the same procedures than whites in this system by a fairly large gap.
.
I think you know as well as I do that it's environmental poverty, lack of pre natal care, lack of education, lack of access, no insurance, substance abuse, that is the cause of more blacks dying in the medical system.
It's really transparent what you are trying to do here.
Sure...just as much as it is lack of all of those things being the reason they live in ghetto's and are shot by police more often because crime rates are higher there. So from your post, you are saying that blacks, in general, have a disposition to die more than others?
My whole point was to be transparent here.....not trying to hide anything. Just wondering why these places are not under the same scrutiny for killing MORE than LEO ever has. The arguments for LEO being racist and targeting blacks is just as valid as one for healthcare doing the same.
Aside from that, these figures are taken with whites and blacks at the same healthcare facilities and medicare providers.
originally posted by: jtma508
It's no secret that minorities have higher densities in lower economic areas. These same areas are often 'food deserts' where high quality, fresh vegetables, fruits and proteins are lacking. Residents of these areas are frequently forced to consume higher quantities of pre-packaged and 'fast' foods. Med-Surg outcomes are highly correlated with the underlying health of the patient. Significantly lower access to preventative health care, delays in seeking care when needed, and diets based on lower quality foods makes a patient more at-risk. Google 'food deserts' and you can read the studies citing increased morbidity and mortality rates.
originally posted by: Vasa Croe
a reply to: Jamie1
I wonder how many of them died in the hospital and how many were shot by LEO versus dying in the street and shot by the same race as the victim.