To determine whether outcome disparities between black and white trauma patients have decreased over the last 10 years.
Pennsylvania Trauma Outcome Study.
We performed an observational cohort study on 191,887 patients admitted to 28 Level 1 and Level II trauma centers. The main outcomes of interest were (1) death, (2) death or major complication, and (3) failure‐to‐rescue. Hospitals were categorized according to the proportion of black patients. Multivariate regression models were used to estimate trends in racial disparities and to assess whether the source of racial disparities was within or between hospitals.
Trauma patients admitted to hospitals with high concentrations of blacks (>20 percent) had a 45 percent higher odds of death (adj : 1.45, 95 percent : 1.09–1.92) and a 73 percent higher odds of death or major complication (adj : 1.73, 95 percent : 1.42–2.11) compared with patients admitted to hospitals treating low proportions of blacks. Blacks and whites admitted to the same hospitals had no difference in mortality (adj : 1.05, 95 percent : 0.87, 1.27) or death or major complications (adj : 1.01; 95 percent : 0.90, 1.13). The odds of overall mortality, and death or major complications have been reduced by 32 percent (adj : 0.68; 95 percent : 0.54–0.86) and 28 percent (adj : 0.72; 95 percent : 0.60–0.85) between 2000 and 2009, respectively. Racial disparities did not change over 10 years.
Despite the overall improvement in outcomes, the gap in quality of care between black and white trauma patients in Pennsylvania has not narrowed over the last 10 years. Racial disparities in trauma are due to the fact that black patients are more likely to be treated in lower quality hospitals compared with whites.