Format

Send to

Choose Destination
See comment in PubMed Commons below
J Am Coll Cardiol. 2003 Apr 2;41(7):1159-66.

The cardiac access longitudinal study. A study of access to invasive cardiology among African American and white patients.

Author information

1
Center for Health Disparities Solutions, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. tlaveist@jhsph.edu

Abstract

OBJECTIVES:

We sought to identify factors contributing to racial disparity in the receipt of coronary angiography (CA).

BACKGROUND:

Numerous studies have demonstrated that African American patients are less likely to receive needed diagnostic and therapeutic coronary procedures than white patients. This report summarizes the methods and findings of a study linking medical records with patient and physician interviews to address racial disparities in the utilization of CA.

METHODS:

This is a retrospective, cross-sectional study conducted in three urban hospitals in Maryland. A total of 9,275 medical records were reviewed, representing all 7,058 cardiac patients admitted in a two-year period. We identified 2,623 patients who, according to American College of Cardiology guidelines, were candidates for receiving CA. A total of 1,669 patients (721 African Americans and 948 whites) and 74% of their physicians were successfully interviewed. Multivariate and hierarchical multivariate logistic regression were used to construct a model of receipt of CA within one year of the hospitalization.

RESULTS:

The unadjusted odds of white patients receiving CA was three times greater than the odds for African American patients (odds ratio [OR] 3.0, 95% confidence interval [CI] 2.4 to 3.7). Adjusting for patients' clinical and social characteristics resulted in a 13% reduction in the OR for race. Adjusting for physician and health care system characteristics reduced the OR by 43%, to 1.7 (95% CI 1.3 to 2.4).

CONCLUSIONS:

Racial disparity in the utilization of CA is a function of differences in the health care system "context" in which African American and white patients obtain care, combined with differences in the specific clinical characteristics of patients.

PMID:
12679217
[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center