Document 0711
 DOCN  M95A0711
 TI    Racial differences in care among hospitalized patients with Pneumocystis
       carinii pneumonia in Chicago, New York, Los Angeles, Miami, and
       Raleigh-Durham.
 DT    9510
 AU    Bennett CL; Horner RD; Weinstein RA; Dickinson GM; DeHovitz JA; Cohn SE;
       Kessler HA; Jacobson J; Goetz MB; Simberkoff M; et al; Department of
       Medicine, Northwestern University, Chicago, IL,; USA.
 SO    Arch Intern Med. 1995 Aug 7-21;155(15):1586-92. Unique Identifier :
       AIDSLINE MED/95344289
 AB    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
       anti-PCP 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 patients 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 in-hospital 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.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS/ETHNOLOGY/
       MORTALITY/*THERAPY  Blacks/STATISTICS & NUMER DATA  Chicago  Comparative
       Study  Female  Florida  Hispanic Americans/STATISTICS & NUMER DATA
       Hospitalization  Hospitals, Urban/STATISTICS & NUMER DATA/*STANDARDS
       Human  Logistic Models  Los Angeles  Male  Medical Records  Middle Age
       Minority Groups/*STATISTICS & NUMER DATA  Multivariate Analysis  New
       York City  North Carolina  Patient Care Planning/*STANDARDS  Pneumonia,
       Pneumocystis carinii/*DIAGNOSIS/ETHNOLOGY/MORTALITY/  *THERAPY
       Retrospective Studies  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       Non-P.H.S.  Support, U.S. Gov't, P.H.S.  Veterans/STATISTICS & NUMER
       DATA  Whites/STATISTICS & NUMER DATA  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).