Titre :
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Race, quality of care, and outcomes of elderly patients hospitalized with heart failure. (2003)
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Auteurs :
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Saif-S RATHORE ;
Joanne-M FOODY ;
Edward-P HAVRANEK ;
Jeph HERRIN ;
Harlan-M KRUMHOLZ ;
Frederick-A MASOUDI ;
Diana-L ORDIN ;
Grace-L Smith ;
Pamela WOLFE ;
. YONGFEI WANG ;
Colorado Foundation for Medical Care. Aurora. USA ;
Division of Cardiology. Department of Medicine. Denver Health Medical Center. Denver. USA ;
Division of Cardiology. Department of Medicine. University of Colorado Health Sciences Center. Denver. USA ;
Section of Cardiovascular Medicine. Department of Internal Medicine. Yale University School of Medicine. New Haven. CT. USA
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Type de document :
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Article
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Dans :
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JAMA - Journal of the american medical association (vol. 289, n° 19, 2003)
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Pagination :
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2517-2524
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Langues:
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Anglais
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Mots-clés :
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Insuffisance cardiaque
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Hospitalisation
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Etats Unis
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Amérique
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Ethnie
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Qualité
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Soins
;
Pronostic
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Personne âgée
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Homme
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Appareil circulatoire [pathologie]
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Cardiopathie
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Amérique du Nord
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Réhospitalisation
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Medicare
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Résumé :
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[BDSP. Notice produite par INIST-CNRS WbqO2R0x. Diffusion soumise à autorisation]. Context Black patients hospitalized with heart failure reportedly receive poorer quality of care and have worse outcomes than white patients. Because previous studies have been based on selected patient populations treated more than a decade ago, it is unclear if racial differences in quality of care and outcomes currently exist in the United States. Objective To evaluate differences in quality of care and patient outcomes between black and white Medicare beneficiaries hospitalized with heart failure. Design Retrospective analysis of medical record data systematically collected for the National Heart Failure Project. Setting and Patients Nationwide US sample of 29732 fee-for-service Medicare beneficiaries hospitalized with heart failure in 1998 and 1999. Main Outcome Measures Prescription of angiotensin-converting enzyme (ACE) inhibitors, measurement of left ventricular ejection fraction (LVEF), readmission within 1 year of discharge, and mortality within 30 days and 1 year of admission. Results Black patients and white patients had similar crude rates of LVEF assessment (67.8% black vs 66.6% white ; P=29). Among patients classified as ideal for ACE inhibitor use, black patients had higher crude rates of ACE inhibitor use than white patients (81.0% vs 73.8% white ; P<. but had similar rates of ace inhibitor or angiotensin receptor blocker use black vs white p="08)." after multivariable adjustment patients comparable lvef assessment ratio confidence interval remained more likely to be prescribed inhibitors cl than were in an adjusted analysis there no significant racial differences the prescription arbs rr higher readmission within year discharge lower crude and mortality patients. a slightly rate at risk conclusions medicare hospitalized with heart failure received quality care up hospitalization did>
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