Skip to main content
PMC home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1999 Jun;91(6):322–327.

Pulmonary sarcoidosis: comparison of patients at a university and a municipal hospital.

H Yeager Jr 1, D L Rabin 1, S R Stein 1, M S Richardson 1, R Singh 1, M A Devine 1, M Freedman 1
PMCID: PMC2608497  PMID: 10388256

Abstract

Charts and radiographs of sarcoidosis patients seen at a private university hospital and at a municipal hospital were reviewed to determine whether there was a difference in the severity of disease retrospectively. A standardized abstract form was used to identify and abstract information on new and continuing sarcoidosis patients seen at either Georgetown University Medical Center (GUMC) or District of Columbia General Hospital (DCGH) during a 2-year period. Because there were too few white sarcoidosis patients for comparison, analysis was done for African-American patients only. African-American patients at GUMC were slightly older, with a higher percentage of women. For GUMC patients, 76% had private insurance and 21% had public insurance, and for DCGH patients, one-half had public insurance and 29% had no insurance. Significantly fewer GUMC patients (7% versus 36%) reported moderate to severe dyspnea. Chest radiographs showed a larger percentage of patients with stage 1 disease at GUMC and more patients with stage 4 disease at DCGH. Spirometry showed more impairment of forced expired volume in one second (FEV1) in GUMC patients, but diffusing capacity of the lung for carbon monoxide (DLCO) values were significantly lower among DCGH patients. Less than 8% of GUMC patients showed disease progression compared with almost one-third of DCGH patients. These results demonstrate that substantially less severe pulmonary sarcoidosis was seen in African-American patients treated at a private, nonprofit university hospital compared with a municipal hospital. Factors that determine the use of municipal hospitals, such as limited financial access to care and sources of patients, may have played a major role in the differences seen.

Full text

PDF
322

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bresnitz E. A., Strom B. L. Epidemiology of sarcoidosis. Epidemiol Rev. 1983;5:124–156. doi: 10.1093/oxfordjournals.epirev.a036255. [DOI] [PubMed] [Google Scholar]
  2. Carr W., Zeitel L., Weiss K. Variations in asthma hospitalizations and deaths in New York City. Am J Public Health. 1992 Jan;82(1):59–65. doi: 10.2105/ajph.82.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Gibson G. J., Prescott R. J., Muers M. F., Middleton W. G., Mitchell D. N., Connolly C. K., Harrison B. D. British Thoracic Society Sarcoidosis study: effects of long term corticosteroid treatment. Thorax. 1996 Mar;51(3):238–247. doi: 10.1136/thx.51.3.238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gideon N. M., Mannino D. M. Sarcoidosis mortality in the United States 1979-1991: an analysis of multiple-cause mortality data. Am J Med. 1996 Apr;100(4):423–427. doi: 10.1016/S0002-9343(97)89518-6. [DOI] [PubMed] [Google Scholar]
  5. Mahler D. A., Wells C. K. Evaluation of clinical methods for rating dyspnea. Chest. 1988 Mar;93(3):580–586. doi: 10.1378/chest.93.3.580. [DOI] [PubMed] [Google Scholar]
  6. Marder D., Targonski P., Orris P., Persky V., Addington W. Effect of racial and socioeconomic factors on asthma mortality in Chicago. Chest. 1992 Jun;101(6 Suppl):426S–429S. doi: 10.1378/chest.101.6_supplement.426s. [DOI] [PubMed] [Google Scholar]
  7. Newman L. S., Rose C. S., Maier L. A. Sarcoidosis. N Engl J Med. 1997 Apr 24;336(17):1224–1234. doi: 10.1056/NEJM199704243361706. [DOI] [PubMed] [Google Scholar]
  8. Rybicki B. A., Major M., Popovich J., Jr, Maliarik M. J., Iannuzzi M. C. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. Am J Epidemiol. 1997 Feb 1;145(3):234–241. doi: 10.1093/oxfordjournals.aje.a009096. [DOI] [PubMed] [Google Scholar]
  9. SCADDING J. G. Prognosis of intrathoracic sarcoidosis in England. A review of 136 cases after five years' observation. Br Med J. 1961 Nov 4;2(5261):1165–1172. doi: 10.1136/bmj.2.5261.1165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Shapiro M. F., Park R. E., Keesey J., Brook R. H. Mortality differences between New York City municipal and voluntary hospitals, for selected conditions. Am J Public Health. 1993 Jul;83(7):1024–1026. doi: 10.2105/ajph.83.7.1024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Sharma O. P., Johnson R. Airway obstruction in sarcoidosis. A study of 123 nonsmoking black American patients with sarcoidosis. Chest. 1988 Aug;94(2):343–346. doi: 10.1378/chest.94.2.343. [DOI] [PubMed] [Google Scholar]
  12. Shea S., Misra D., Ehrlich M. H., Field L., Francis C. K. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med. 1992 Sep 10;327(11):776–781. doi: 10.1056/NEJM199209103271107. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES