Racial Differences in the Use of Revascularization Procedures After Coronary Angiography

摘要: Objective. —To assess whether rates of coronary revascularization procedures differ between blacks and whites after angiography is performed to the relationship these hospital characteristics. Design. —A retrospective cohort study using 1987 1988 data on claims characteristics from Health Care Financing Administration. Setting. —One thousand four hundred twenty-nine acute care hospitals that provide in United States. Patients. national sample 27485 Medicare Part A enrollees, aged 65 74 years, who underwent inpatient for heart disease 1987. Main Outcome Measure. —The adjusted odds with either angioplasty or bypass graft surgery within 90 days relative blacks, controlling age, sex, region, Medicaid eligibility, principal diagnosis, comorbid diagnoses, ownership, teaching status, urban/suburban rural location, availability procedures. Results. —White men women were significantly more likely than black women, respectively, receive a procedure (57% 50% vs 40% 34%, both P >.20 interaction terms). Conclusions. —Among are angiography. Racial differences similar magnitude occur all types hospitals. These may reflect overuse underuse but they unlikely access cardiologists perform Potential explanations include unmeasured clinical socioeconomic factors, differing patient preferences, racial bias at performing ( JAMA . 1993;269:2642-2646)