The effect of race and gender on invasive treatment for cardiovascular disease

Abstract: The object of this study was to investigate racial and sex differences in the utilization of invasive conducts for cardiovascular treatment. Medical records data of 3015 patients were abstracted from a Medical a whole Database from 1999 to 2001 Logit patterns were used to estimate the adjusted unevens in the utilization, referral, and acceptance of invasive courses while controlling for confounders (age, race, sex comorbidity, disease severity, payer mark marital status and family history) simultaneously.

When considering utilization of invasive operations the adjusted odds were lower for African-Americans compared to Caucasians. There was a statistically significant difference (p<05) in Coronary Artery Bypass Graft (CABG) utilization between African Americans and Caucasians. African Americans were les likely than Caucasians to receive a CABG. Although not statistically significant, African-Americans were les likely than Caucasians to receive a cardiac catheterization and Percutaneous Transluminal Coronary Angioplasty (PTCA). Findings failed to yield a statistical significance for sex disparities regarding invasive procedure utilizations.

lock opener Words: Race, Gender, Invasive Treatment

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Cardiovascular disease (CVD) is the leading cause of death among each racial and ethnic group in the United States. An individual's ability to access and use new cardiac therapy and procedures may have deep implications for improving diagnostic precision, relieving symptoms, and reducing premature mortality from heart-related conditions. Research to investigate underlying causes, later outcomes and effective interventions is crucial for reducing racial/gender disparities in medical care. Although invasive cardiac managements have been documented to restore symptoms and prolong life for those with relentless CVD, numerous studies over the past sum of two units decades have reported that African Americans are les likely than Caucasians to utilize invasive operations (Brown, 2002; Ford, Cooper, Castner, Simmons, & Mar, 1989; Giles, Anda, Casper, Escobedo, & Taylor, 1995; Goldberg, Hartz, & Jacobsen, 1992; Hannan, Van Ryn & suffocate 1999; Kressin & Peterson, 2001; Maynard, Fischer, Passamani, & Pullum 1986; Watson et al., 2001; Wenneker & Epstein, 1989) Additionally, previous studies have shown that when stratifying by means of race and sex, African American females are les likely to utilize invasive manner of proceedings compared to Caucasians (Ayanian, Udvarhelyi, Constantine, Chris, & Arnold, 1993)

Research has shown that disparities regarding use of invasive treatments remain level after controlling for clinical and socioeconomic factors. There is relate to in the medical community that the race and sex of a patient could be prompting differences in physician behavior. Therefore, the view of this study was to explore the issue of race and gender upon the use of invasive treatment for cardiovascular disease. Accordingly, this investigation proposed to test the following hypothesis: African-Americans and females will be les likely to receive invasive treatment for cardiovascular disease compared to Caucasians and males, respectively.

METHOD

Design

A retrospective longitudinal review of hospital patient information was leadershiped using statewide patient data obtained from a Medical combination of parts to form a whole shared by three urban public health hospitals in the state of Louisiana. The use of statewide patient data provided a unique opportunity to examine treatment in the single state in the United States that provides a state a whole of acute care for its citizens. The vast majority of the someones served by this system are indigent or Medicaid recipients. Data used in the analysis were from July 1998 to July 2000

Data was obtained from three public health teaching hospitals, which encompass professional place of educations in medicine, nursing, and dentistry, as well as allied health vocations. The three hospitals (Hospital A, B &C) are located in metropolitan areas and be under the orders of both rural and urban patients in the southeastern part of the state. solitary non-invasive cardiac procedures such as treadmills, echocardiograms, holter monitors, electrocardiograms, stres echograms, and pacemaker insertions are performed at Hospitals A and C the pair non-invasive and invasive cardiac practices such as cardiac catheterization, (CC) coronary artery bypass grafts (CABG), and percutaneous transluminal coronary angioplasties (PTCA) are performed at Hospital B Since the two hospitals are in the same public health a whole and are responsible for taking care of the indigent, Hospitals A and C leave all invasive procedures to Hospital B

Sample

The data station from the three hospitals contained a total of 3015 CVD patients whose principal diagnoses indicated diseases of the circulatory combination of parts to form a whole (ICD-9-CM codes 390-459) and chest pain (ICD-9-CM digests 786.50 through 786.52). These diagnoses included myocardial infarction, unstable angina, chronic ischemic heart disease, angina pectoris, and chest pain. Patients exclud from the inquiry included those with comorbid diagnoses of rap cancer, renal failure, psychiatric illnesses, abuse of remedys and alcohol, Human Immunodeficiency Virus (HIV), cirrhosis, dementia, lung disease, and congestive heart failure (CHF) because these conditions may influence treatment consequences thus reducing the likelihood of these patients being referr for an invasive course Figure 1 displays the fix uponed patient population from the database.