Abstract 18743: Lack of Evidence of Higher 30-day All-cause Readmission Among Older African American (vs. White) Medicare Beneficiaries Hospitalized for Heart Failure
Bibliographic record
Abstract
Background: A recent study using administrative data suggested that older African American heart failure (HF) patients may have higher 30-day readmissions than whites do (PMC3332042). However, to what extent these associations are intrinsic remains unclear. Methods: Of the 8042 Medicare beneficiaries hospitalized for HF and discharged alive from 106 U.S. hospitals (1998-2001), 1994 were African American and 6048 were white. Using propensity scores for being an African American, we assembled a matched cohort of 1799 pairs of African American and white patients balanced on 33 baseline characteristics. Results: Matched patients (N=3598) had a mean age of 74 (±11) years with no racial difference (p=0.599). 30-day all-cause readmission occurred in 20% and 22% of matched African Americans and whites, respectively (HR, 0.89; 95% CI, 0.77-1.03; p=0.110; Figure, left panel). In the pre-match cohort (N=8042), African Americans were younger (77 v 72 years for whites; p<0.001) and had similar unadjusted 30-day all-cause readmission (20% v. 20% for whites; p=0.075), but had significantly lower risk when adjusted for age and sex (HR, 0.87; 95% CI, 0.77-0.98; p=0.018; Figure, right panel) but not for propensity scores (HR, 0.90; 95% CI, 0.80-1.02; p=0.101). Among matched patients, race had no association with 30-day HF readmission or all-cause mortality. Conclusions: Findings from our propensity-matched study suggest that in a cohort of hospitalized African American and white HF patients who were balanced on 33 baseline characteristics, race had no independent association with 30-day all-cause or HF readmissions or all-cause mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".