ArticleCritical care medicine2020
Treatment in Disproportionately Minority Hospitals Is Associated With Increased Risk of Mortality in Sepsis: A National Analysis.
Article in Critical care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Rapid systematic review on risks and outcomes of sepsis: the influence of risk factors associated with health inequalities.International journal for equity in health · 2024Pooled it
- Ethnic Disparities in Deep Sedation of Patients with Acute Respiratory Distress Syndrome in the United States: Secondary Analysis of a Multicenter Randomized Trial.Annals of the American Thoracic Society · 2024Trial
- Associations Between Social Drivers of Health and Intervention Reach During Implementation of a Supervised Walking Program.Medical care · 2026Observational
- Language Serving Hospitals and Their Impact on Readmission for Surgical Patients With a Non-English Primary Language: A Retrospective Cohort Study.Annals of surgery · 2026Article
- Upstream Factors Associated With Hospitalization in Black- and Minority-Serving Hospitals.JAMA network open · 2026Observational
- Maternity Care Access and Infant Mortality.JAMA network open · 2025Article
- Alternative Approaches to Characterizing Disparate Care by Race, Ethnicity, and Insurance Between Hospitals.International journal of environmental research and public health · 2025Article
- Article
- Racial and Ethnic Disparities in Failure-to-Rescue After Postoperative Sepsis After Noncardiac Surgery.Anesthesia and analgesia · 2025Article
- Outcomes of major cardiac operations are not improved for black patients at black-serving institutions.JTCVS open · 2025Article
- Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.Health services research · 2025Article
- Race and Ethnicity Disparities in Management and Outcomes of Critically Ill Adults with Acute Respiratory Failure.Critical care clinics · 2024Review
- Disparities in end-of-life care for minoritized racial and ethnic patients during terminal hospitalizations in New York State.Journal of the American Geriatrics Society · 2024Article
- Hospital-Onset Sepsis Warrants Expanded Investigation and Consideration as a Unique Clinical Entity.Chest · 2024Review
- Trajectories of State-Level Sepsis-Related Mortality by Race and Ethnicity Group in the United States.Journal of clinical medicine · 2024Article
- In-Hospital vs 30-Day Sepsis Mortality at US Safety-Net and Non-Safety-Net Hospitals.JAMA network open · 2024Article
- Racial Disparities in Length of Stay Among Severely Ill Patients Presenting With Sepsis and Acute Respiratory Failure.JAMA network open · 2023Article
- The impact of ethnic background on ICU care and outcome in sepsis and septic shock - A retrospective multicenter analysis on 17,949 patients.BMC infectious diseases · 2023Article
- A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks.The Milbank quarterly · 2023Article
- Use of hospitals in the New York City Metropolitan Region, by race: how separate? How equal in resources and quality?BMC health services research · 2022Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesTreatment in a disproportionately minority-serving hospital has been associated with worse outcomes in a variety of illnesses. We examined the association of treatment in disproportionately minority hospitals on outcomes in patients with sepsis across the United States.
designRetrospective cohort analysis. Disproportionately minority hospitals were defined as hospitals having twice the relative minority patient population than the surrounding geographical mean. Minority hospitals for Black and Hispanic patient populations were identified based on U.S. Census demographic information. A multivariate model employing a validated algorithm for mortality in sepsis using administrative data was used.
settingThe National Inpatient Sample from 2008 to 2014. PATIENTS: Patients over 18 years of age with sepsis.
interventionsNone. MEASUREMENTS AND MAIN
resultsA total of 4,221,221 patients with sepsis were identified. Of these, 612,217 patients (14.5%) were treated at hospitals disproportionately serving the black community (Black hospitals), whereas 181,141 (4.3%) were treated at hospitals disproportionately serving the Hispanic community (Hispanic hospitals). After multivariate analysis, treatment in a Black hospital was associated with a 4% higher risk of mortality compared to treatment in a nonminority hospital (odds ratio, 1.04; 95% CI, 1.03-1.05; p < 0.01). Treatment in a Hispanic hospital was associated with a 9% higher risk of mortality (odds ratio, 1.09; 95% CI, 1.07-1.11; p < 0.01). Median hospital length of stay was almost 1 day longer at each of the disproportionately minority hospitals (nonminority hospitals: 5.9 d; interquartile range, 3.1-11.0 d vs Hispanic: 6.9 d; interquartile range, 3.6-12.9 d and Black: 6.7 d, interquartile range, 3.4-13.2 d; both p < 0.01).
conclusionsPatients with sepsis regardless of race who were treated in disproportionately high minority hospitals suffered significantly higher rates of in-hospital mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.