Racial Differences in Care Among Hospitalized Patients With Pneumocystis carinii Pneumonia in Chicago, New York, Los Angeles, Miami, and Raleigh-Durham

Charles L. Bennett, Ronnie D. Homer, Robert A. Weinstein, Gordon M. Dickinson, Jack A. Dehovitz, Susan E. Cohn, Harold A. Kessler, Jeffrey Jacobson, Matthew B. Goetz, Michael Simberkoff, Dave Pitrak, W. Lance George, Stuart C. Gilman, Martin F. Shapiro

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Background: While strategies for medical care for human immunodeficiency virus-related Pneumocystis carinii pneumonia (PCP) are well established, racial variations in care have not been evaluated. Objective: To determine whether sociodemographic characteristics influence patterns of care and patient outcomes, by analyzing the use of diagnostic tests and antiPCP medications and in-hospital mortality rates for persons who were hospitalized with human immunodeficiency virus-related PCP. Methods: Retrospective chart review of a cohort of 627 Veterans Administration (VA) patients and 1547 non-VA patients with empirically treated or cytologically confirmed PCP who were hospitalized from 1987 to 1990. Outcomes included representative aspects of the process of care for PCP and short-term mortality rates. Results: Among VA patients, black and Hispanic paents were not significantly different from white patients with regard to in-hospital mortality rates, use and timing of a bronchoscopy, or receipt of timely anti-PCP medications. Among non-VA patients, black and Hispanic patients were more likely to die in the hospital and less likely to undergo a diagnostic bronchoscopy in the first 2 days of hospitalization. These racial and ethnic group differences in the use of a bronchoscopy and inhospital mortality among non-VA patients were almost fully accounted for by differences in health insurance status and hospital characteristics. Conclusions: Racial factors do not appear to be an important determinant of the intensity of diagnostic or therapeutic care among patients who are hospitalized with PCP. Variations in care are largely attributable to differences in health insurance and admitting hospital characteristics.

Original languageEnglish (US)
Pages (from-to)1586-1592
Number of pages7
JournalArchives of internal medicine
Volume155
Issue number15
DOIs
StatePublished - Aug 7 1995

ASJC Scopus subject areas

  • Internal Medicine

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    Bennett, C. L., Homer, R. D., Weinstein, R. A., Dickinson, G. M., Dehovitz, J. A., Cohn, S. E., Kessler, H. A., Jacobson, J., Goetz, M. B., Simberkoff, M., Pitrak, D., George, W. L., Gilman, S. C., & Shapiro, M. F. (1995). Racial Differences in Care Among Hospitalized Patients With Pneumocystis carinii Pneumonia in Chicago, New York, Los Angeles, Miami, and Raleigh-Durham. Archives of internal medicine, 155(15), 1586-1592. https://doi.org/10.1001/archinte.1995.00430150042005