Racial differences in access to high-quality cardiac surgeons.
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.
Mukamel
D B
DB
Department of Community and Preventive Medicine, University of Rochester Medical Center, NY 14642, USA. dana_mukamel@urmc.rochester.edu
Murthy
A S
AS
Weimer
D L
DL
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*