Ethnic disparities in care following acute coronary syndromes among Asian Americans and Pacific Islanders during the initial hospitalization.
Despite the fact that Asian Americans and Pacific Islanders are the fastest growing minority population in the United States, little is known about their treatment patterns and outcomes, particularly for Asian American and Pacific Islander sub-groups. Multivariable logistic regression was used to compare differences in revascularization and mortality rates following acute coronary syndromes among Asian American and Pacific Islander sub-groups [Japanese (n = 1342), Chinese (n = 249), Filipino (n = 314), Native Hawaiian (n = 361)) and Caucasians (n = 569)] during the initial hospitalization using administrative (claims) data from 1997 to 1999. Analyses were stratified by gender and controlled for age, diabetes mellitus, congestive heart failure, acute myocardial infarction, ACG morbidity level and system of care. We found that the type of procedures received during the initial hospitalization differed according to patient ethnicity for male patients but not for female ones. Compared to Caucasians, male Asian Amercian and Pacific Islanders patients were less likely to undergo percutaneous coronary interventions and more likely to undergo coronary artery bypass graft surgery. In the future, a more comprehensive outcomes study is needed, to examine the impact of any interethnic differences in revascularization rates on intermediate and long-term mortality, patient satisfaction, and self-reported functioning and well-being. The trend toward higher mortality following acute coronary syndromes among Asian Americans and Pacific Islander males emphasizes the importance of such a study.
Taira
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DA
Hawaii Medical Service Association, Care Management, Honolulu 96808-0860, USA. deb_taira@hmsa.com
Seto
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TB
Marciel
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C
D001213:Asian; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States; D044465:White People