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01-10-2018 | Original Article

Race Differences in Gastrostomy Tube Placement After Stroke in Majority-White, Minority-Serving, and Racially Integrated US Hospitals

Authors: Roland Faigle, Lisa A. Cooper, Rebecca F. Gottesman

Published in: Dysphagia | Issue 5/2018

Abstract

We sought to determine individual and system contributions to race disparities in percutaneous endoscopic gastrostomy (PEG) tube placement after stroke. Ischemic stroke admissions were identified from the Nationwide Inpatient Sample between 2007 and 2011. Hospitals were categorized based on the percentage of ethnic/racial minority stroke patients (< 25% ethnic/racial minorities [“majority-white hospitals”], 25–50% ethnic/racial minorities [“racially integrated hospitals”], or > 50% ethnic/racial minorities [“minority-serving hospitals”]). Logistic regression was used to evaluate the association between ethnicity/race and PEG utilization within and between the different hospital strata. Among 246,825 stroke admissions, patients receiving care in minority-serving hospitals had higher odds of PEG compared to patients in majority-white hospitals, regardless of individual patient race (adjusted odds ratio [OR] 1.24, 95% CI 1.12–1.38). Ethnic/racial minorities had higher odds of PEG than whites in any hospital strata; however, this discrepancy was largest in majority-white hospitals (OR 1.62, 95% CI 1.48–1.76), and smallest in minority-serving hospitals (OR 1.22, 95% CI 1.11–1.33; p for interaction < 0.001). Ethnic/racial minority patients had similar odds of PEG in any hospital strata, while white patients had increasing odds of PEG in racially integrated and minority-serving compared to majority-white hospitals (OR 1.28, 95% CI 1.15–1.43 in racially integrated, and OR 1.39, 95% CI 1.23–1.57 in minority-serving, compared to majority-white hospitals, p for trend < 0.001). The likelihood of PEG after ischemic stroke was increased in minority-serving compared to majority-white hospitals. White patients had higher odds of PEG in minority-serving compared to majority-white hospitals, indicating a systemic difference in PEG placement across hospitals.

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Title: Race Differences in Gastrostomy Tube Placement After Stroke in Majority-White, Minority-Serving, and Racially Integrated US Hospitals
Authors: Roland Faigle
Lisa A. Cooper
Rebecca F. Gottesman
Publication date: 01-10-2018
Publisher: Springer US
Published in: Dysphagia / Issue 5/2018
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-018-9882-y

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Race Differences in Gastrostomy Tube Placement After Stroke in Majority-White, Minority-Serving, and Racially Integrated US Hospitals

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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