Volume 8, Issue 7
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.
Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.
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.
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.
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Li, S., Chen, A., Mead, K. (2013). Racial disparities in the use of cardiac revascularization: Does local hospital capacity matter?