Race and sex differences in rates of invasive cardiac procedures in US hospitals. Data from the National Hospital Discharge Survey.

Cardiovascular Health Studies Branch, Centers for Disease Control and Prevention, Atlanta, Ga.
Archives of Internal Medicine (Impact Factor: 13.25). 03/1995; 155(3):318-24. DOI: 10.1001/archinte.155.3.318
Source: PubMed

ABSTRACT Lower rates of invasive cardiac procedures have been reported for blacks and women than for white men. However, few studies have adjusted for differences in the type of hospital of admission, insurance status, and disease severity. SETTING, DESIGN, AND PARTICIPANTS: Data from the National Hospital Discharge Survey were used to investigate race and sex differences in rates of cardiac catheterization, percutaneous transluminal coronary angioplasty, and coronary artery bypass surgery among 10,348 persons hospitalized for acute myocardial infarction.
White men consistently had the highest procedure rates, followed by white women, black men, and black women. After matching for the hospital of admission and adjusting for age, in-hospital mortality, health insurance, and hospital transfer rates (with white men as the referent), the odds ratios for cardiac catheterization were 0.67 (95% confidence interval [CI], 0.51 to 0.87) for black men, 0.72 (95% CI, 0.63 to 0.83) for white women, and 0.50 (95% CI, 0.37 to 0.68) for black women. Similar race-sex differences were noted for percutaneous transluminal coronary angioplasty and coronary artery bypass surgery.
Race and sex differentials in the rates of invasive cardiac procedures remained despite matching for the hospital of admission and controlling for other factors that influence procedure rates, suggesting that the race and sex of the patient influence the use of these procedures.

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    • "Studies of racial and ethnic differences in cardiovascular care provide some of the most convincing evidence of healthcare disparities. The most rigorous studies in this area assess both potential underuse and overuse of services and appropriateness of care by controlling for disease severity using well-established clinical and diagnostic criteria (e.g., Schneider et al., 2001; Ayanian et al., 1993; Allison et al., 1996; Weitzman et al., 1997) or matched patient controls (Giles et al., 1995). Several studies, for example, have assessed differences in treatment regimen following coronary angiography, a key diagnostic procedure. "
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