Coronary arteriography and coronary bypass survey among whites and other racial groups relative to hospital-based incidence rates for coronary artery disease: findings from NHDS.

To assess racial differences in health care utilization for coronary artery disease (CAD) the data of the National Hospital Discharge Survey (NHDS) from 1979-84 were examined. Discharge rates for acute myocardial infarction (AMI) were utilized as a measure of hospital-based incidence and relative need for the designated cardiac procedures. Although 35-74 year old Black men had discharge rates of AMI that were 77 per cent of those observed for White men, they underwent coronary arteriography half as often and were only a third as likely to have coronary artery bypass graft (CABG) surgery. Black women in this age range were hospitalized at a slightly higher rate than White women for AMI, yet experienced a 19 per cent lower rate of coronary arteriography and a 52 per cent lower rate of CABG surgery. These data suggest a racial bias in the pattern of care delivered for CAD in US hospitals at the present time.

[1]  L. Haywood.  Coronary heart disease mortality/morbidity and risk in blacks. I: Clinical manifestations and diagnostic criteria: the experience with the Beta Blocker Heart Attack Trial. , 1984, American heart journal.

[2]  G. Cutter,et al.  Issues in the natural history and treatment of coronary heart disease in black populations: surgical treatment. , 1984, American heart journal.

[3]  G. Payne,et al.  Report of an NHLBI Working Conference on Coronary Heart Disease in Black PopulationsPreface , 1984 .

[4]  E. Ford,et al.  In-hospital mortality rates from acute myocardial infarction by race in U.S. hospitals: findings from the National Hospital Discharge Survey. , 1987, Circulation.

[5]  C. Maynard,et al.  Blacks in the coronary artery surgery study (CASS): race and clinical decision making. , 1986, American journal of public health.

[6]  D. Strogatz,et al.  Use of medical care for chest pain: differences between blacks and whites. , 1990, American journal of public health.

[7]  J. Ferlinz,et al.  Coronary artery disease in blacks of lower socioeconomic status: angiographic findings from the Cook County Hospital Heart Disease Registry. , 1988, American heart journal.

[8]  R. Gillum.  Coronary heart disease in black populations. I. Mortality and morbidity. , 1982, American heart journal.

[9]  S. Willich,et al.  Effects of gender and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women. , 1987, Journal of the American College of Cardiology.

[10]  R. Gillum.  Acute myocardial infarction in the United States, 1970-1983. , 1987, American heart journal.

[11]  C. Maynard,et al.  Blacks in the Coronary Artery Surgery Study: risk factors and coronary artery disease. , 1986, Circulation.