Differences between Hispanics and non-Hispanic Whites in use of hospital procedures for cerebrovascular disease.
OBJECTIVE
This study examined disparities in the use of in-hospital diagnostic and therapeutic procedures for Hispanics with cerebrovascular disease compared to their non-Hispanic White counterparts.


METHODS
This is a cross-sectional study using 1996 hospital administrative data.


METHODS
Hispanics and non-Hispanic Whites with diagnosis codes indicating occlusion or stenosis of precerebral arteries or transient cerebral ischemia were included, with a total of 18,674 New York patients (5.1% Hispanic) and 22,624 California patients (11.1% Hispanic). Adjusted odds ratios compared Hispanics with non-Hispanic Whites for six diagnostic and therapeutic procedures for cerebrovascular disease, controlling for patient and hospital characteristics.


RESULTS
Hispanics had higher rates of non-invasive diagnostic procedures (head CT scan, head/neck diagnostic ultrasound, echocardiogram, and head MRI). The odds of invasive diagnostic testing (cerebral arteriogram) and therapeutic procedures (carotid endarterectomy) were lower for Hispanics. Most findings remained unchanged in logistic regression models with patient and hospital characteristics. Adding a measure of the concentration of Hispanic patients by hospital eliminated or reduced observed differences between Hispanics and Whites.


CONCLUSIONS
Controlling for each hospital's experience with Hispanic patients eliminated or reduced the magnitude of the disparities in procedure use, suggesting that the concentration of Hispanic patients in a hospital is associated with different patterns of procedure use.
Elixhauser
Anne
A
Agency for Healthcare Research and Quality, Rockville, MD 20852, USA. aelixhau@ahrq.gov
Weinick
Robin M
RM
Betancourt
Joseph R
JR
Andrews
Roxanne M
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003954:Diagnostic Services / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000145:classification / Q000706:statistics & numerical data*; D006302:Health Services Research; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010818:Practice Patterns, Physicians' / Q000145:classification / Q000706:statistics & numerical data*; D011336:Probability; D013812:Therapeutics / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data*