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  1. Fulltext. Access to hospitals with high-technology cardiac services : how is race important ?

    Article - En anglais

    Fulltext.

    Objectives

    Relatively few hospitals in the United States offer high-technology cardiac services (cardiac catheterization, bypass surgery, or angioplasty).

    This study examined the association between race and admission to a hospital offering those services.

    Methods

    Records of 11 410 patients admitted with acute myocardial infarction to hospitals in New York State in 1986 were analyzed.

    Results

    Approximately one third of both White and Black patients presented to hospitals offering high-technology cardiac services.

    However, in a multivariate model adjusting for home-to-hospital distance, the White-to-Black odds ratio for likelihood of presentation to such a hospital was 1.68 (95% confidence interval=1.42,1.98).

    This discrepancy between the observed and « distance-adjusted » probalities reflected three phenomena :

    • (1) patients presented to nearby hospitals ;

    • (2) Blacks were more likely to live near high-technology hospitals ;

    • and (3) there were racial differences in travel patterns.

    For example, when the nearest hospitals did not include a high-technology hospital.

    Whites were more likely than Blacks to travel beyond those nearest hospitals to a high-technology hospital.

    Conclusions

    Whites and Blacks present equally to hospitals offering high-technology cardiac services at the time of acute myocardial infarction.

    However, there are important underlying racial differences in geographic proximity and tendencies to travel to those hospitals.

    Mots-clés Pascal : Accessibilité, Soin, Hôpital, Service hospitalier, Cardiologie, Equipement biomédical, Race, Homme, Infarctus, Myocarde, Chirurgie, Exploration, New York, Système santé, Etats Unis, Amérique du Nord, Amérique, Cardiopathie coronaire, Appareil circulatoire pathologie

    Mots-clés Pascal anglais : Accessibility, Care, Hospital, Hospital ward, Cardiology, Biomedical equipment, Race, Human, Infarct, Myocardium, Surgery, Exploration, New York, Health system, United States, North America, America, Coronary heart disease, Cardiovascular disease

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

    Cote : 95-0220402

    Code Inist : 002B30A01B. Création : 09/06/1995.