Interracial Access to Selected Cardiac Procedures for Patients Hospitalized with Coronary Artery Disease in New York State

Hannan, Edward L.; Kilburn, Harold; O’Donnell, Joseph F.; Lukacik, Gary; Shields, Eileen

doi:10.1097/00005650-199105000-00004

Cited by 172 publications

(39 citation statements)

References 20 publications

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“…Multiple studies have revealed that when a testing or treatment modality is new, white patients have better access than minority patients. [27][28][29] It is possible that in our population white patients with ASD receive care beyond the basic standard care, whereas nonwhite children receive only the minimal care necessary. 30 Finally, nonwhite and white children may present with similar complaints with similar rates of referral, but nonwhite children may not follow-up with referrals at the same rate as white children.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Racial and ethnic differences exist in age at diagnosis and early access to mental and behavioral health services among children with autism spectrum disorders (ASDs). ASDs are also associated with increased rates of other medical comorbidities that may require specialty care.WHAT THIS STUDY ADDS: Significant racial and ethnic differences in use of specialty care and specialty procedures exist among children with documented ASD. abstract OBJECTIVE: To describe racial differences in use of specialty care among children with autism spectrum disorder. METHODS:We identified patients ages 2 to 21 years with an International Classification of Diseases, Ninth Revision code of autism (299.0) seen from 2000 to 2011 at a major academic health center by using a research patient data repository and determined rates of specialty provider visits and procedures by race. We then used logistic regression to determine the associations of rates of subspecialty visits and procedures with race and ethnicity, controlling for gender, age, and payer type. RESULTS:We identified 3615 patients (2935 white, 243 Hispanic, 188 African American, and 249 other). The most striking differences were in use of gastroenterology (GI)/nutrition services. Nonwhite children were less likely to use GI/nutrition specialty providers (African American, odds ratio = 0. CONCLUSIONS:We found racial and ethnic differences among children diagnosed with autism in use of care and procedures. Possible explanations for these findings include differences in presentation, referral rates, or referral follow through. Pediatrics 2013;132:94-100

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

et al. 2013

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“…The concern for differential use in revascularization procedures for coronary artery disease in racial and ethnic minorities was raised as early as 1989, 12 with several early studies demonstrating a lower rate of cardiac catheterization, angioplasty, and coronary artery bypass grafting in black patients compared with white patients [13][14][15][16][17] and, to a lesser degree, Hispanic and Asian patients. 15 Relative to white patients, these disparities in the use of revascularization procedures persisted in black patients when controlling for the degree of coronary artery disease 16 and after adjusting for the severity of underlying disease.…”

Section: Discussionmentioning

confidence: 99%

“…15 Relative to white patients, these disparities in the use of revascularization procedures persisted in black patients when controlling for the degree of coronary artery disease 16 and after adjusting for the severity of underlying disease. 16 After the introduction of DES into the United States in April 2003, they were rapidly adopted. During this time period, black patients were found to be less likely to receive DES than white patients.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Race and Ethnicity on Outcomes With Drug-Eluting and Bare Metal Stents

et al. 2013

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We sought to evaluate long-term PCI outcomes for racial and ethnic minorities in the modern era, as well as DES use, safety, and effectiveness, using a large nationally representative patient sample. We examined data from the National Cardiovascular Data Registry CathPCI Registry linked to Medicare claims data to identify any differences in patterns of DES and BMS use among racial and ethnic groups, to describe and compare outcomes after PCI for each racial and ethnic group, and to assess comparative long-term outcomes after DES versus BMS use within each racial and ethnic group. Background

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] The consequences of these racial disparities in cardiac procedure use remain unclear, however. Although certain studies 3,15 have associated lower procedure use among blacks with lower long-term survival rates, others have not.…”

mentioning

confidence: 99%

Influence of Racial Disparities in Procedure Use on Functional Status Outcomes Among Patients With Coronary Artery Disease

et al. 2005

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Background— Although black cardiac patients receive fewer revascularization procedures than whites, it is unclear whether this has a detrimental impact on outcomes. The objective of our study was to compare 6-month functional status and angina outcomes among blacks and whites with documented coronary disease and to assess whether differential use of revascularization procedures affects these outcomes. Methods and Results— We identified a prospective cohort of 1534 white and 337 black patients undergoing cardiac catheterization between August 1998 and April 2001. Health status was assessed at baseline and 6 months with the Short-Form 36 (SF-36) Health Survey and the Seattle Angina Questionnaire (SAQ) Angina Frequency Scale. Compared with whites, blacks received fewer coronary revascularization procedures (52.5% versus 66.0%; P <0.01). By 6 months, blacks had similar mortality (odds ratio, 1.03; 95% CI, 0.57 to 1.9) but worse scores in 5 SF-36 domains (physical, social, role physical, role emotional, and mental health function). Blacks also reported higher rates of angina at 6 months than whites (34.2% versus 24.6%; P <0.01). After adjustment for baseline functional status and clinical and demographic variables, blacks had significantly worse summary physical component scores, summary mental component scores, and SAQ Angina Frequency Scale scores. However, differences in physical component summary scores and SAQ scores between blacks and whites were no longer significant after adjustment for revascularization status. Conclusions— Our study is among the first to document greater symptoms and functional impairment among black cardiac patients relative to whites. Differential use of coronary revascularization may contribute to the poorer functional outcomes observed among black patients with documented coronary disease.

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Interracial Access to Selected Cardiac Procedures for Patients Hospitalized with Coronary Artery Disease in New York State

Cited by 172 publications

References 20 publications

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

Effect of Race and Ethnicity on Outcomes With Drug-Eluting and Bare Metal Stents

Influence of Racial Disparities in Procedure Use on Functional Status Outcomes Among Patients With Coronary Artery Disease

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