title: Racial variations in cardiology care among hospitalized older heart failure patients.
abstract: In this retrospective follow-up study, the authors examined the association between race and the receipt of cardiology care in 1062 Medicare beneficiaries 65 years of age and older who were hospitalized with heart failure. The primary outcome measure was receipt of care from a cardiologist (via admission or consultation). Using logistic regression analyses, crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI) of receipt of cardiology care were estimated for nonwhite versus white patients. Two hundred (19%) patients were nonwhites and 483 (46%) patients received care from cardiologists. Proportion of patients receiving cardiology care was lower among nonwhite patients (35% versus 48% among whites; P = 0.001), and nonwhite race was associated with a lower odds of receiving cardiology care (crude OR = 0.57; 95%CI = 0.42-0.79). After adjustment for various patient characteristics and process-of-care variables, the magnitude and precision of the association between nonwhite race and a lower odds of receiving care from a cardiologist remained unchanged (adjusted OR = 0.43; 95% CI = 0.30-0.62). These findings suggest that nonwhite elderly hospitalized heart failure patients are less likely to be cared for by cardiologists.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham (UAB), AL 35294-2041, USA. aahmed@uab.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.forename: Richard V
authors.initials: RV
authors.lastname: Sims
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
authors.forename: James F
authors.initials: JF
authors.lastname: DeLong
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
mesh_terms: D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000208:ethnology* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D006278:Medicare; D012189:Retrospective Studies; D014481:United States