Racial and ethnic disparities in cardiac catheterization for acute myocardial infarction in the United States, 1995--2001
Bertoni, A.G.; Goonan, K.L.; Bonds, D.E.; Whitt, M.C.; Goff, D.C.; Brancati, F.L.
Journal of the National Medical Association 97(3): 317-323
2005
ISSN/ISBN: 0027-9684 PMID: 15779495 Document Number: 592919
Objective: To examine recent trends in racial and ethnic disparities in cardiac catheterization for acute myocardial infarction (AMI) in the USA, to determine whether disparities documented from the 1980s through mid-1990s persist, and evaluate whether patient and hospital characteristics are associated with any observed disparities. Methods: Cross-sectional analyses of 585 710 white, 51 369 black and 31 923 Hispanic discharges from hospitals in the Nationwide Inpatient Sample (which includes data on all discharges from 951 representative hospitals in 23 states) that had performed cardiac catheterization from 1995-2001 with a primary diagnosis of AMI. Adjusted procedure rates and prevalence ratios (PR) were computed to compare catheterization rates by race and ethnicity. Measurements and Main Results: Catheterization rates were higher for whites than blacks for all years examined; rates among Hispanics increased during this period and approached the rate among whites. After adjustment for age, demographics, comorbidity, year and hospital characteristics, the rates (per 100 discharges) were 58.4 for whites, 50.1 for blacks (PR, 0.87; 95% CI: 0.84-0.91) and 55.2 for Hispanics (PR, 0.95; 95% CI: 0.90-0.99). Conclusions: These nationwide data suggest blacks remain less likely than whites and Hispanics to undergo catheterization during a hospitalization for AMI. Whether this disparity stems from patient or provider factors remains to be determined.