Race, gender, and cardiovascular disease: do disparities exist at hospitals that serve majority black populations when patients present with ischemic heart disease and myocardial infarction?
A retrospective review of data was conducted to determine whether disparities in cardiovascular disease treatment occurred in three public teaching hospitals in Louisiana when patients presented for care with ischemic heart disease (IHD) or acute myocardial infarction (MI). Multinomial logit models were used to estimate the adjusted odds in the utilization of invasive procedures, while controlling for confounders (i.e., age, marital status, comorbidities, payer type, diabetes, and cigarette addiction) simultaneously. No significant racial disparities were found for cardiac catheterization (CC) or Percutaneous Transluminal Coronary Angioplasty (PTCA). However, Blacks had a lower adjusted odds ratio (p < .05) for coronary artery bypass graft surgery (CABG) than did Whites. Furthermore, models failed to show significant gender disparities for invasive procedure utilizations. These disparities, or lack of, may be partially due to patient demographic characteristics or study limitations. Future research should focus on physician referrals and patient preferences.
Caillier
James Gerard
JG
Bowie State University, Master of Public Administration Program, USA. JCaillier@bowiestate.edu
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D008137:Longitudinal Studies; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology* / Q000628:therapy*; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies