Racial differences in access to high-quality cardiac surgeons

Am J Public Health. 2000 Nov;90(11):1774-7. doi: 10.2105/ajph.90.11.1774.

Abstract

Objectives: Racial differences in access to cardiac artery bypass graft (CABG) surgery are well documented. This study extends the literature by examining racial differences in access to high-quality cardiac surgeons.

Methods: The analyses included 11,296 CABG surgeries in New York State in 1996. Regression techniques were used to identify significant associations between a patient's race, health maintenance organization (HMO) enrollment, and the quality of the surgeon performing the surgery, measured by the surgeon's risk-adjusted mortality rate (RAMR).

Results: Non-Whites were more likely than Whites to have access to surgeons of higher RAMR, by 11.7% among HMO enrollees (1-tailed P < .1) and by 5.4% among fee-for-service enrollees (1-tailed P < .05).

Conclusions: Even when racial minorities do gain access to CABG services, they are more likely that non-Whites to receive care from lower-quality providers.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data
  • Child
  • Child, Preschool
  • Coronary Artery Bypass / mortality
  • Coronary Artery Bypass / standards
  • Coronary Artery Bypass / statistics & numerical data*
  • Fee-for-Service Plans / statistics & numerical data
  • Female
  • Health Maintenance Organizations / statistics & numerical data
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • New York / epidemiology
  • Quality of Health Care / statistics & numerical data*
  • Regression Analysis
  • White People / statistics & numerical data*