PMID- 15011808
OWN - NLM
STAT- MEDLINE
DCOM- 20040416
LR  - 20211203
IS  - 1088-0224 (Print)
IS  - 1088-0224 (Linking)
VI  - 10
IP  - 2 Pt 1
DP  - 2004 Feb
TI  - Examining healthcare disparities in a disease management population.
PG  - 81-8
AB  - OBJECTIVES: To examine whether racial disparities in healthcare exist in a heart 
      failure population and to estimate the impact of disease management (DM) on any 
      identified disparities. STUDY DESIGN: Before-after cohort study. PATIENTS AND 
      METHODS: A total of 2619 high-risk heart failure patients (2129 whites and 490 
      blacks) who participated in a DM program for at least 90 days between July 2001 
      and July 2003 were examined. Analysis was stratified by sex and age (< 65 years 
      and > or = 65 years). Functional status as measured by the New York Heart 
      Association (NYHA) classification system and mental and physical quality of life 
      (QOL) as measured by the 8-Item Short-Form Health Survey were used to assess 
      disparities between races. RESULTS: At baseline, 33.7% of black versus 44.3% of 
      white older women and 32.6% of black versus 48.5% of white older men were at NYHA 
      level I or II (P < .01 and P = .005, respectively). At the most current 
      measurement, the differences between the cohorts disappeared. Results were 
      similar for the younger male, but not the younger female, cohort. The only QOL 
      disparities at baseline were in favor of blacks. Both races had significant 
      increases in mean mental and physical QOL scores (P < .001) after involvement in 
      the DM program. CONCLUSIONS: Disparities in QOL were not observed between blacks 
      and whites at baseline or over the course of the study. Disparities in functional 
      status at baseline disappeared over time, implying that DM may help reduce 
      disparities and maintain equity in healthcare outcomes.
FAU - Walker, David R
AU  - Walker DR
AD  - CorSolutions, Inc, 9500 West Bryn Mawr Ave, Suite 500, Rosemont, IL 60018, USA. 
      dwalker@corsolutions.com
FAU - Stern, Patricia M
AU  - Stern PM
FAU - Landis, Darryl L
AU  - Landis DL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
MH  - Aged
MH  - Cardiac Output, Low/ethnology/*therapy
MH  - Cohort Studies
MH  - *Disease Management
MH  - Female
MH  - *Health Services Accessibility
MH  - Health Services Research
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - *Quality of Life
MH  - *Racial Groups
MH  - *Social Justice
MH  - United States
EDAT- 2004/03/12 05:00
MHDA- 2004/04/17 05:00
CRDT- 2004/03/12 05:00
PHST- 2004/03/12 05:00 [pubmed]
PHST- 2004/04/17 05:00 [medline]
PHST- 2004/03/12 05:00 [entrez]
AID - 2507 [pii]
PST - ppublish
SO  - Am J Manag Care. 2004 Feb;10(2 Pt 1):81-8.