University of Wisconsin–Madison Medical College of Wisconsin

Does Racial Disparity Exist Among Inpatient Admissions for Heart Attacks in Wisconsin?

Charles A. Gusho, BS

WMJ. 2021;120(Suppl 1):S48-S53.

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ABSTRACT

Objective: Acute myocardial infarction (AMI), or heart attack, carries a high inpatient death risk. Few national studies suggest race affects the outcomes of inpatients with AMI. In Wisconsin, an assessment of racial disparity among admissions for AMI is lacking.

Methods: Using the Wisconsin State Inpatient Database from 2016, demographics and outcomes for AMI admissions were analyzed. The goal was to compare demographic and hospitalization characteristics between non-Hispanic White patients and Black, Indigenous, and People of Color (BIPOC).

Results: A total of 6,002 non-Hispanic Whites and 546 BIPOC cases were identified. BIPOC were younger than non-Hispanic White inpatients (median age, 59 years vs 68 years, respectively; P < 0.001). Median length of stay was shorter in non-Hispanic White versus BIPOC (2 days vs 3 days; P = 0.021), and mean total charges were higher for BIPOC than non-Hispanic Whites ($74,716 vs $65,384, respectively; P = 0.002). Using a risk-adjusted model, inpatient mortality was increased for patients over 55 years of age (odds ratio [OR] 2.166; 95% CI, 1-3; P = 0.001) and women (OR 1.319; 95% CI, 1-1.6; P = 0.03). Race (BIPOC vs non-Hispanic White) was not predictive of inpatient death on univariable analysis (OR 0.771; 95% CI, 0.4-1.2; P = 0.283).

Conclusion: It appears BIPOC have longer hospital stays and incur higher charges than non-Hispanic White patients, though race does not affect mortality risk. Among Wisconsin counties with higher proportions of AMI, these data may enable strategic recommendation of hospitalized patients or permit risk stratification to identify disparity and encourage equitable care.


Author Affiliations: Medical College of Wisconsin-Green Bay, De Pere, Wis (Gusho).
Corresponding Author: Charles A. Gusho, BS, 110 Grant St, De Pere, WI 54115; phone: 414.218.9350; email cgusho@mcw.edu; ORCID ID 0000 0002 8897 3688.
Funding/Support: None declared.
Financial Disclosures: None declared.
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