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  1. Underuse of cardiac procedures : Do Women, ethnic minorities, and the uninsured fail to receive needed revascularization ?

    Article - En anglais

    Background 

    Women, ethnic minorities, and uninsured persons receive fewer cardiac procedures than affluent white male patients do, but rates of use are crude indicators of quality.

    The important question is, Do women, minorities, and the uninsured fail to receive cardiac procedures when they need them ?

    Objective 

    To measure receipt of necessary coronary artery bypass graft (CABG) surgery and percutaneous transluminal coronary angioplasty (PTCA) overall ; by patient sex, ethnicity, and payer status ; and by availability of on-site revascularization.

    Design 

    Retrospective, randomized medical record review.

    Setting 

    13 of the 24 hospitals in New York City that provide coronary angiography.

    Patients 

    631 patients who had coronary angiography in 1992 and met the RAND expert panel criteria for necessary revascularization.

    Measurements 

    The percentage of patients who had CABG surgery or PTCA was measured, as were variations in use rates by sex, ethnic group, insurance status, and availability of on-site revascularization.

    Clinical and laboratory data were retrieved from medical records to identify patients who met the panel criteria for necessary revascularization.

    Receipt of revascularization was determined from state reports, medical records, and information provided by cardiologists.

    Results 

    Overall, 74% (95% Cl, 71% to 77%) of patients who met the panel criteria for necessary revascularization had CABG surgery or PTCA (underuse rate, 26%). (...)

    Mots-clés Pascal : Plastie, Artère coronaire, Dérivation, Ethnie, Sexe, Malade, Statut économique, Assurance maladie, Indication, Rétrospective, Traitement, Homme, Chirurgie

    Mots-clés Pascal anglais : Plasty, Coronary artery, Bypass, Ethnic group, Sex, Patient, Economic status, Health insurance, Indication, Retrospective, Treatment, Human, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0120203

    Code Inist : 002B25E. Création : 16/11/1999.