Document Detail


Disparities in the receipt of cardiac revascularization procedures between blacks and whites: an analysis of secular trends.
MedLine Citation:
PMID:  18646331     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Mortality rates for coronary heart disease (CHD) have declined markedly since the early 1970s. However, CHD remains the number one cause of death in the United States. The decline in mortality has been attributed to declines in CHD risk factors (tobacco use, hypertension) and the increase in protective behaviors (exercise, weight control). Medical interventions may have also contributed to the decline in mortality. Despite these declines in mortality, racial disparities persist between Blacks and Whites. The purpose of this study was to examine the differences in receipt of cardiac catheterization, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft.
METHODS: Data from the National Hospital Discharge Survey were used for the analysis. Patients who were Black or White and > or = 40 years of age were included. Independent variables included age at discharge, sex, race, and insurance coverage. Multivariate logistic regression was used to derive odds ratios for the receipt of the three procedures by age group, sex, insurance type, and race.
RESULTS: Significant differences (P < .05) in the odds of receipt of all of cardiac catheterization, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft were found by age group, insurance type, sex, and race. While the disparities persisted from 1979 to 2004, the magnitude of the differences decreased during this time period.
CONCLUSION: Disparities by race, sex, and insurance type existed in the receipt of three cardiac procedures. Although differences are narrowing over time, further in-depth studies are needed to elucidate the patient, physician, and healthcare system factors associated with the disparity in receipt of these beneficial procedures.
Authors:
C Perry Brown; Levi Ross; Ivette Lopez; Angela Thornton; Gebre-Egziabher Kiros
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Ethnicity & disease     Volume:  18     ISSN:  1049-510X     ISO Abbreviation:  Ethn Dis     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-09-23     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  9109034     Medline TA:  Ethn Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S2-112-7     Citation Subset:  IM    
Affiliation:
Institute of Public Health, Division of Pharmacy Practice (AT), College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida, USA. perry.brown@famu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group / statistics & numerical data*
Aged
Angioplasty, Balloon, Coronary / utilization*
Coronary Artery Bypass / utilization*
Coronary Disease / mortality,  therapy*
European Continental Ancestry Group / statistics & numerical data*
Female
Healthcare Disparities*
Humans
Logistic Models
Male
Middle Aged
Risk Factors
United States / epidemiology
Utilization Review
Grant Support
ID/Acronym/Agency:
1 P20 MD 000501-04/MD/NIMHD NIH HHS; G12 RR0 3020/RR/NCRR NIH HHS; G12 RR003020-200024/RR/NCRR NIH HHS
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