Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation

Abbott Ethan E.; Buckler David G.; Hsu Jesse Y.Jacoby Sara F.Abella Benjamin S.Richardson Lynne D.Carr Brendan G.Zebrowski Alexis M.

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Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation

机译：Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation

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Racial and racialized economic residential segregation has been empirically associated with outcomes across multiple health conditions but not yet explored in relation to out-of-hospital cardiac arrest (OHCA). We sought to examine if measures of racial and economic residential segregation are associated with differences in survival to discharge after OHCA for Black and White Medicare beneficiaries. Utilizing age-eligible Medicare fee-for-service claims data from 2013 to 2015, we identified OHCA claims and determined survival to discharge. The primary predictor, residential segregation, was calculated using the index of concentration at the extremes (ICE) for the beneficiary residential ZIP code. Multilevel modified Poisson regression models were used to determine the association of OHCA outcomes and ZIP code level ICE measures. In total, 194,263 OHCA cases were identified among beneficiaries residing in 75% of US ZIP codes. Black beneficiaries exhibited 12.1% survival to discharge, compared with 12.5% of White beneficiaries. In fully adjusted models of the three ICE measures accounting for differences in treating hospital characteristics, there was as high as a 28% (RR 1.28, CI 1.23-1.26) higher relative likelihood of survival to discharge in the most segregated White ZIP codes (Q5) as compared to the most segregated Black ZIP codes (Q1). Racial residential segregation is independently associated with disparities in OHCA outcomes; among Medicare beneficiaries who generated a claim after suffering an OHCA, ICE measures of racial segregation are associated with a lower likelihood of survival to discharge for those living in the most segregated Black and lower income quintiles compared to higher quintiles.

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《Journal of urban health: Bulletin of the New York Academy of Medicine》 |2022年第6期|998-1011|共14页
作者
Abbott Ethan E.; Buckler David G.; Hsu Jesse Y.Jacoby Sara F.Abella Benjamin S.Richardson Lynne D.Carr Brendan G.Zebrowski Alexis M.;
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作者单位

Icahn School of Medicine at Mount Sinai,Icahn Sch Med Mt Sinai;

Perelman Sch Med,Univ Penn;

Sch Nursing,Univ PennCtr Resuscitat Sci,Univ Penn;

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原文格式 PDF
正文语种英语
中图分类医药、卫生;
关键词
Out-of-hospital cardiac arrest; Health disparities; Racial residential segregation; REGIONAL-VARIATION; DISPARITIES; EXTREMES; INDEX; US; ASSOCIATION; CODES; POLARIZATION; VALIDATION; OUTCOMES;

Survival After Out-of-Hospital Cardiac Arrest: The Role of Racial Residential Segregation

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