Document Detail


Pulmonary sarcoidosis: comparison of patients at a university and a municipal hospital.
MedLine Citation:
PMID:  10388256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Charts and radiographs of sarcoidosis patients seen at a private university hospital and at a municipal hospital were reviewed to determine whether there was a difference in the severity of disease retrospectively. A standardized abstract form was used to identify and abstract information on new and continuing sarcoidosis patients seen at either Georgetown University Medical Center (GUMC) or District of Columbia General Hospital (DCGH) during a 2-year period. Because there were too few white sarcoidosis patients for comparison, analysis was done for African-American patients only. African-American patients at GUMC were slightly older, with a higher percentage of women. For GUMC patients, 76% had private insurance and 21% had public insurance, and for DCGH patients, one-half had public insurance and 29% had no insurance. Significantly fewer GUMC patients (7% versus 36%) reported moderate to severe dyspnea. Chest radiographs showed a larger percentage of patients with stage 1 disease at GUMC and more patients with stage 4 disease at DCGH. Spirometry showed more impairment of forced expired volume in one second (FEV1) in GUMC patients, but diffusing capacity of the lung for carbon monoxide (DLCO) values were significantly lower among DCGH patients. Less than 8% of GUMC patients showed disease progression compared with almost one-third of DCGH patients. These results demonstrate that substantially less severe pulmonary sarcoidosis was seen in African-American patients treated at a private, nonprofit university hospital compared with a municipal hospital. Factors that determine the use of municipal hospitals, such as limited financial access to care and sources of patients, may have played a major role in the differences seen.
Authors:
H Yeager; D L Rabin; S R Stein; M S Richardson; R Singh; M A Devine; M Freedman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  91     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-08-10     Completed Date:  1999-08-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  322-7     Citation Subset:  IM    
Affiliation:
Department of Medicine (Pulmonary and Critical Care), Georgetown University Medical Center, Washington, DC 20007, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans / statistics & numerical data
Chi-Square Distribution
Female
Hospitals, Municipal*
Hospitals, University*
Humans
Insurance, Health / statistics & numerical data
Male
Respiratory Function Tests
Retrospective Studies
Sarcoidosis, Pulmonary / diagnosis*,  ethnology
Severity of Illness Index
Treatment Outcome
Grant Support
ID/Acronym/Agency:
N01-AI82514/AI/NIAID NIH HHS
Comments/Corrections
Comment In:
J Natl Med Assoc. 1999 Jun;91(6):327-8   [PMID:  10388257 ]

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