Table 2.
Black- and White-Specific End-of-Life Hospital Intensity Measures among Three Mutually Exclusive Groups of Hospitals Categorized by Their Concentration of Black Admissions (From Predominantly White-Serving Hospitals to Least and Most Concentrated Black-Serving Hospitals), Pennsylvania, 2001–2007
| Predominantly white-serving hospitals (N = 87) | Black-serving; least concentrated (N = 66) | Black-serving; most concentrated (N = 29) | |||||
|---|---|---|---|---|---|---|---|
| Variable | Black | White | Black | White | Black | White | p-valuea(black/white) |
| Admissions, n (%) | 617 (0.67) | 91,040 (99) | 6513 (4.1) | 151,880 (96) | 28,779 (29) | 71,907 (71) | |
| Observed proportion | |||||||
| ICU admission | 0.46 (.37–.59) | 0.66 (0.54–0.74)*** | 0.62 (0.53–0.69) | 0.7 (0.63–0.79) | 0.72 (0.62–0.79) | 0.051/<0.001 | |
| ICU LOS, days | 4.3 (3.8–5.5) | 6.3 (5.3–7.8)* | 6.2 (5.3–7.2) | 8.5 (7.1–10) | 8.4 (7.8–11) | <0.001/<0.001 | |
| Intubation/MV | 0.13 (0.1–0.17) | 0.28 (0.25–0.34)*** | 0.22 (0.18–0.26) | 0.33 (0.28–0.38)** | 0.31 (0.24–0.36) | 0.043/<0.001 | |
| Hemodialysis | 0.016 (0–0.047) | 0.11 (0.076–0.15)*** | 0.044 (0.031–0.059) | 0.1 (0.09–0.12)*** | 0.05 (0.038–0.058) | 0.431/<0.001 | |
| Tracheostomy | 0.004 (0.002–0.010) | 0.034 (0.013–0.042)*** | 0.02 (0.012–0.028) | 0.057 (0.031–0.075) | 0.048 (0.027–0.076) | <0.001/<0.001 | |
| Gastrostomy | 0.021 (0.015–0.028) | 0.052 (0.033–0.067)*** | 0.032 (0.024–0.039) | 0.069 (0.055–0.074)*** | 0.047 (0.031–0.061) | 0.007/<0.001 | |
| Expected proportion | |||||||
| ICU admission | 0.53 (0.47–0.57) | 0.68 (0.65–0.71)*** | 0.57 (0.55–0.59) | 0.7 (0.66–0.72)*** | 0.61 (0.57–0.65) | 0.238/<0.001 | |
| ICU LOS, days | 3.9 (3.4–4.1) | 6.5 (6–6.9)*** | 4.2 (3.9–4.4) | 6.4 (6.2–7)*** | 4.4 (4.1–5.3) | 0.482/<0.001 | |
| Intubation/MV | 0.18 (0.16–0.2) | 0.32 (0.3–0.36)*** | 0.21 (0.2–0.23) | 0.34 (0.29–0.37)*** | 0.24 (0.21–0.29) | 0.544/<0.001 | |
| Hemodialysis | 0.039 (0.036–0.043) | 0.11 (0.1–0.12)*** | 0.043 (0.039–0.045) | 0.11 (0.099–0.12)*** | 0.043 (0.039–0.052) | 0.084/<0.001 | |
| Tracheostomy | 0.017 (0.014–0.019) | 0.049 (0.044–0.057)*** | 0.019 (0.018–0.022) | 0.051 (0.045–0.064)*** | 0.026 (0.02–0.043) | 0.193/<0.001 | |
| Gastrostomy | 0.032 (0.03–0.033) | 0.059 (0.055–0.064)*** | 0.032 (0.03–0.033) | 0.062 (0.059–0.065)*** | 0.035 (0.033–0.039) | 0.025/<0.001 | |
| O-to-E ratios | |||||||
| ICU admission | 0.88 (0.7–1.1) | 0.97 (0.78–1.1)*** | 1.1 (0.92–1.2) | 1 (0.91–1.1)*** | 1.2 (1–1.3) | 0.093/<0.001 | |
| ICU LOS, days | 1.2 (0.98–1.4) | 0.99 (0.8–1.2)*** | 1.4 (1.2–1.7) | 1.3 (1.1–1.5)*** | 2 (1.5–2.3) | <0.001/<0.001 | |
| Intubation/MV | 0.7 (0.56–0.92) | 0.9 (0.77–1)*** | 1 (0.91–1.3) | 1 (0.87–1.1)*** | 1.2 (1–1.4) | 0.016/<0.001 | |
| Hemodialysis | 0.42 (0.0015–1.1) | 0.95 (0.63–1.4) | 1 (0.74–1.4) | 0.96 (0.88–1.1) | 1 (0.86–1.2) | 0.974/<0.001 | |
| Tracheostomy | 0.26 (0.1–0.53) | 0.67 (0.28–0.84)*** | 0.91 (0.61–1.2) | 1 (0.69–1.2)*** | 1.6 (1.3–1.9) | <0.001/<0.001 | |
| Gastrostomy | 0.66 (0.46–0.93) | 0.85 (0.56–1.2)* | 0.98 (0.75–1.2) | 1.1 (0.87–1.2)*** | 1.3 (1–1.5) | 0.056/<0.001 | |
| EOL-I Index | −0.67 (0.73) | −0.21 (0.82)*** | 0.37 (0.72) | 0.48 (0.76)*** | 1.2 (0.9) | <0.001/<0.001 | |
Values are median (interquartile range) or mean (standard deviation).
p < 0.05; **p < 0.01; ***p < 0.001; p values reflect within-group comparisons of black- versus white-specific measures of EOL intensity using Wilcoxon signed-ranks tests, a nonparametric analog to the paired t-test.
p values reflect across-group test for trend for black-specific and white-specific measures of EOL intensity, respectively, by using an extension of the Kruskal-Wallis test that accounts for ordered categories (e.g., three-group comparison for white-specific measures and two-group comparison for black-specific measures).
EOL, end of life; EOL-I, end-of-life intensity.