Document Type

Journal Article

Publication Date





Volume 8, Issue 7

Inclusive Pages

Article number e69855


Angioplasty, Balloon, Coronary--statistics & numerical data; Coronary Artery Bypass--statistics & numerical data; Myocardial Infarction--surgery



To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources

Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design

The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical models were used to determine the extent to which racial disparities in procedure use were attributable to the variation in local hospital capacity.

Principal Findings

Blacks were less likely than whites to receive CABG (9.1% vs. 5.8%; p


County variation in cardiac revascularization use rates helps explain the observed racial disparities. While smaller hospital capacity is associated with lower procedure rates for both racial groups, the impact is found to be larger on blacks. Therefore, consequences of fewer medical resources may be particularly pronounced for blacks, compared with whites.


Reproduced with permission of PLoS ONE

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

Peer Reviewed


Open Access


Included in

Health Policy Commons



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