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Treatment and Outcomes for Congestive Heart Failure by Race/Ethnicity in TRICARE

Bagchi, Ann D., PhD*; Stewart, Kate, PhD; McLaughlin, Catherine, PhD; Higgins, Patricia, PhD, MPH; Croghan, Thomas, MD

doi: 10.1097/MLR.0b013e318207ef87
Original Articles

Background Equitable access to health insurance coverage may improve outcomes of care for chronic health conditions and mitigate racial/ethnic health disparities. This study examines racial/ethnic disparities in the treatment and outcomes of care for TRICARE beneficiaries with congestive heart failure (CHF).

Methods Using a retrospective cohort analysis, we examined demographic characteristics, sources of care, and comorbid conditions for 2183 beneficiaries of the Military Health System's TRICARE program (representing 115,584 beneficiaries after adjusting for survey weights) with CHF. Treatments included use of CHF-related medications, while the outcome of interest was any CHF-related potentially avoidable hospitalizations (PAHs).

Results While African Americans were less likely than whites to have received beta blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers following a CHF diagnosis (P<0.0001). Hispanics were, in some cases, equally likely as whites to receive pharmacological treatments for CHF. In multivariate models, there were no significant racial/ethnic differences in the odds of a PAH; age greater than 65 was the most significant predictor of a PAH.

Conclusions This study suggests that although there are some racial and ethnic disparities in the receipt of pharmacological therapy for CHF among TRICARE beneficiaries, these differences do not translate into disparities in the likelihood of a PAH. The findings support previous research suggesting that equal access to care may mitigate racial/ethnic health disparities.

*Mathematica Policy Research, Princeton, NJ

Mathematica Policy Research, Washington, DC

Mathematica Policy Research Inc, Ann Arbor, MI

Supported by the Department of Defense Center for Health Care Management Studies.

Reprints: Ann D. Bagchi, PhD, Mathematica Policy Research, 600 Alexander Park, Princeton, NJ 08540. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.