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Differences in mortality among patients with community-acquired pneumonia in California by ethnicity and hospital characteristics

  • Jennifer S Haas
    Correspondence
    Requests for reprints should be addressed to Jennifer S. Haas, MD, MSPH, Division of General Internal Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA
    Affiliations
    Institute for Health Policy Studies (JSH, MLD, YYH, DJR), University of California, San Francisco, California, USA

    Department of Medicine (JSH), University of California, San Francisco, San Francisco, California, USA

    Division of General Internal Medicine (JSH), San Francisco General Hospital, San Francisco, California, USA
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  • Mitzi L Dean
    Affiliations
    Institute for Health Policy Studies (JSH, MLD, YYH, DJR), University of California, San Francisco, California, USA
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  • YunYi Hung
    Affiliations
    Institute for Health Policy Studies (JSH, MLD, YYH, DJR), University of California, San Francisco, California, USA
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  • Deborah J Rennie
    Affiliations
    Institute for Health Policy Studies (JSH, MLD, YYH, DJR), University of California, San Francisco, California, USA
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      Abstract

      Purpose

      To determine ethnic disparities in mortality for patients with community-acquired pneumonia, and the potential effects of hospital characteristics on disparities, we compared the risk-adjusted mortality of white, African American, Hispanic, and Asian American patients hospitalized for community-acquired pneumonia.

      Methods

      We studied patients discharged with community-acquired pneumonia in 1996 from an acute care hospital in California (n = 54,874). Logistic regression models were used to examine the association between ethnicity and hospital characteristics and 30-day mortality after adjusting for clinical characteristics.

      Results

      The overall 30-day mortality was 12.2%. After adjustment for demographic, clinical, and hospital characteristics, Hispanic (odds ratio [OR] = 0.81; 95% confidence interval [CI]: 0.73 to 0.90) and Asian American patients (OR = 0.88; 95% CI: 0.77 to 1.00) had lower mortality than did white patients, whereas African Americans had a similar mortality to whites (OR = 0.93; 95% CI: 0.83 to 1.06). There were no overall differences in mortality by hospital characteristics (i.e., teaching status, rural location, and public or district hospital).

      Conclusion

      Hispanics and Asian Americans have a lower risk of death from community-acquired pneumonia than whites in California. No overall differences in mortality were observed by hospital characteristics.
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