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Am J Public Health ; 90(11): 1774-7, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11076249

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.


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