title: Racial differences in access to high-quality cardiac surgeons.
abstract: OBJECTIVE
  Racial differences in access to cardiac artery bypass graft (CABG) surgery are well documented. This study extends the literature by examining racial differences in access to high-quality cardiac surgeons.
  
  
  METHODS
  The analyses included 11,296 CABG surgeries in New York State in 1996. Regression techniques were used to identify significant associations between a patient's race, health maintenance organization (HMO) enrollment, and the quality of the surgeon performing the surgery, measured by the surgeon's risk-adjusted mortality rate (RAMR).
  
  
  RESULTS
  Non-Whites were more likely than Whites to have access to surgeons of higher RAMR, by 11.7% among HMO enrollees (1-tailed P < .1) and by 5.4% among fee-for-service enrollees (1-tailed P < .05).
  
  
  CONCLUSIONS
  Even when racial minorities do gain access to CABG services, they are more likely that non-Whites to receive care from lower-quality providers.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester Medical Center, NY 14642, USA. dana_mukamel@urmc.rochester.edu
authors.forename: D B
authors.initials: DB
authors.lastname: Mukamel
authors.forename: A S
authors.initials: AS
authors.lastname: Murthy
authors.forename: D L
authors.initials: DL
authors.lastname: Weimer
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D044465:White People / Q000706:statistics & numerical data*