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New AHCPR-Supported Study Reported in Archives of Internal Medicine

Press Release Date: August 7, 1995

A RAND study supported by the Agency for Health Care Policy and Research in cooperation with the Department of Veterans Affairs, and published in the August 7/21 issue of Archives of Internal Medicine, concludes that racial factors do not appear to be an important determinant of the intensity of diagnostic or therapeutic care among patients who are hospitalized with Pneumocystis carinii pneumonia (PCP). In a report entitled, "Racial Differences in Care Among Hospitalized Patients with Pneumocystis Carinii Pneumonia in Chicago, New York, Los Angeles, Miami, and Raleigh-Durham," researchers found that variations in care are largely attributable to differences in health insurance and admitting hospital characteristics.

While strategies for medical care for human immunodeficiency virus-related PCP are well established, this study is the first to evaluate racial variation in care.

Researchers performed a retrospective review of charts of a cohort of 627 Veterans Administration (VA) patients and 1,547 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.

Among VA patients, it was determined that 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. Racial and ethnic group differences in the use of bronchoscopy and in-hospital mortality among non-VA patients were almost fully accounted for by differences in health insurance status and hospital characteristics.

Note: For details, refer to Bennett CL, Horner RD, Weinstein RA, et al. Racial Differences in Care Among Hospitalized Patients with Pneumocystis carinii Pneumonia in Chicago, New York, Los Angeles, Miami, and Raleigh-Durham. Archives of Internal Medicine, 155(15):1586-1592; August 7/21, 1995.

For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.

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