Disparity in race-specific comorbidities associated with central venous catheter-related bloodstream infection (AHRQ-PSI7)

Abstract

Studies of racial disparities in hospital-level patient safety outcomes typically apply a race-common approach to risk adjustment. Risk factors specific to a minority population may not be identified in a race-common analysis if they represent only a small percentage of total cases. This study identified patient comorbidities and characteristics associated with the likelihood of a venous catheter-related bloodstream infection (Agency for Healthcare Research and Quality Patient Safety Indicator 7 [PSI7]) separately for blacks and whites using race-specific logistic regression models. Hospitals were ranked by the racial disparity in PSI7 and segmented into 4 groups. The analysis identified both black- and white-specific risk factors associated with PSI7. Age showed race-specific reverse association, with younger blacks and older whites more likely to have a PSI7 event. These findings suggest the need for race-specific covariate adjustments in patient outcomes and provide a new context for examining racial disparities.

Keywords: comorbidities; patient safety; racial disparity.

Figure 1

Study data inclusion criteria. Abbreviations: PSI, patient safety indicator; ICD 9, International Classification of Diseases, Ninth Revision, Clinical Modification.