Explaining racial differences in receipt of coronary angiography: the role of physician referral and physician specialty.
The authors examine three hypotheses regarding race differences in utilization of coronary angiography (CA): (1) patients with a cardiology consultation are more likely to obtain a referral for CA, (2) African American patients are less likely to have a cardiology consultation, and (3) among patients referred for CA, there is no difference by race in receipt of the procedure. To determine if they obtained a referral for or received CA, 2.623 candidates for CA were followed. Multivariate models were estimated using logistic regression. Cardiology consultation was associated with referral for CA (OR = 5.1, p < .001). White patients had higher odds of cardiology consultation (OR = 2.2, p < .001). The racial disparity was reduced among patients who received a referral (OR = 1.4, p < .05). Researchers must eliminate racial differences in access to specialty care and variation in referral patterns by physician specialty, and efforts must be targeted to those specialties where greater disparities exist.
LaVeist
Thomas A
TA
Johns Hopkins University, USA.
Arthur
Melanie
M
Morgan
Athol
A
Plantholt
Stephen
S
Rubinstein
Michael
M
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*