Venous thromboembolic disease: comparison of the diagnostic process in blacks and whites.
BACKGROUND
There has been concern that a disproportionate use of some health services exists among races. Whether this applies to patients with pulmonary embolism (PE) or deep venous thrombosis (DVT) has not been determined.


OBJECTIVE
To assess if there is a racial disparity in the application of diagnostic tests for PE or DVT, or in reaching a diagnosis or using medical facilities.


METHODS
A study of cross-sectional samples of hospitalizations during 21 years using data from the National Hospital Discharge Survey.


METHODS
Noninstitutional hospitals in 50 states and the District of Columbia from January 1, 1979, through December 31, 1999.


METHODS
The National Hospital Discharge Survey abstracts demographic and medical information from the medical records of inpatients. For 1979 through 1999, the number of patients sampled ranged annually from 181 000 to 307 000. Measurements The number of sampled patients with DVT and with PE and the number of diagnostic tests performed were determined from the International Classification of Diseases, Ninth Revision, Clinical Modification codes at discharge. A multistage estimation procedure gave an estimate of values for the entire United States.


RESULTS
The age-adjusted rates of diagnosis of PE and of DVT per 100 000 population were not lower in blacks than in whites. Rates of use of radioisotopic lung scans, venous ultrasonography of the lower extremities, and contrast venography were comparable between races. The durations of hospitalization for patients with a primary discharge diagnosis of PE and of DVT were also comparable.


CONCLUSIONS
There is nothing to suggest that diagnostic tests are being withheld, and there is no evidence of a failure to reach a diagnosis in blacks with thromboembolic disease.
Stein
Paul D
PD
Research Department, St Joseph Mercy Oakland Hospital, Pontiac, MI 48341-2985, USA. steinp@trinity-health.org
Hull
Russell D
RD
Patel
Kalpesh C
KC
Olson
Ronald E
RE
Ghali
William A
WA
Alshab
Andrew K
AK
Meyers
Frederick A
FA
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology; D013923:Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D014481:United States; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*