Black persons historically undergo fewer invasive cardiovascular procedures than white persons.
To determine whether acquisition of Medicare health insurance and comprehensive care for severe illness reduce ethnic disparity in use of cardiovascular procedures.
7-year longitudinal analyses in a cohort from the United States Renal Data System.
Health care institutions in the United States.
Nationwide random sample of 4987 adult black and white patients with incident end-stage renal disease (ESRD) from 303 dialysis facilities in 1986 to 1987.
Medical history and service use records, physical examination, and laboratory data.
Main outcome measures were receipt of a coronary catheterization or revascularization procedure before (baseline) and after (follow-up) development of ESRD and acquisition of Medicare, adjusted for clinical and socioeconomic variables.
At baseline, 9.9% of white patients and 2.8% of black patients had had a cardiac procedure ; the odds were almost three times greater in white than in black patients (adjusted odds ratio, 2.92 [95% Cl, 2.04 to 4.18]). During follow-up, white patients were only 1.4 times more likely than black patients to have a procedure (adjusted relative risk, 1.41 [Cl, 1.13 to 1.77]) ; rates were 7.8% for white persons and 8.5% for black persons. (...)
Mots-clés Pascal : Rein pathologie, Caucasoïde, Négroïde, Chirurgie, Appareil circulatoire, Indication, Assurance maladie, Qualité, Soin, Etude cohorte, Traitement, Homme, Etude comparative, Etude longitudinale, Appareil urinaire pathologie
Mots-clés Pascal anglais : Kidney disease, Caucasoid, Negroid, Surgery, Circulatory system, Indication, Health insurance, Quality, Care, Cohort study, Treatment, Human, Comparative study, Follow up study, Urinary system disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0120169
Code Inist : 002B25E. Création : 16/11/1999.