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A new study found that black Americans who are being treated for a stroke actually have worse outcomes when they are treated at hospitals that treat a large number of minority patients. The researchers found no racial disparity at hospitals that treated primarily white stroke patients.

The research team, led by Dr. Lee Schwamm, director of acute stroke services and vice chairman of neurology at Massachusetts General Hospital in Boston, reviewed stroke patient data from 656 hospitals that are participating in the American Stroke Association's Get With the Guidelines program.

Results

The study results were expected to be presented last Wednesday Feb. 7 at the annual American Stroke Association meeting in San Francisco.

The researchers said that the disparities they appeared to find could likely be attributed to the available resources and overall care quality levels. They suspect it works like this: hospitals with a large number of black patients often have fewer resources, which can lead to worse outcomes for those black patients, while hospitals that treat more white people have more resources, which leads to better health outcomes for the black people treated at those hospitals.

“In the adjusted analysis, we found that disparities in care were related more to the hospitals where patients were treated than to race itself,” said Dr. Schwamm.

More Study Findings

The study also found that compared with whites:

• Blacks received fewer clot-busting drugs to treat ischemic stroke
• Blacks received fewer blood thinners upon hospital discharge
• Blacks were less likely to be referred to a program to help them quit smoking

“The important message is that there is a connection between the proportion of patients who are African-American at an individual hospital, and the type of care provided to all patients at those hospitals. This presents an opportunity to begin to look at analyses of disparities in care in a different way,” said Schwamm.

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