RACE AND THE USE OF CARDIOVASCULAR SURGICAL PROCEDURES

心血管疾病是美国成年人死亡的主要原因。 美国的 尽管不久前人们普遍认为， 非裔美国人的心血管疾病发病率低于 现在很少有人相信这是真的。 然而，尽管平价 在心血管疾病的发病率中， 三级保健利用的黑白差异 心血管服务（TCCS），如冠状动脉造影（CA）， 冠状动脉搭桥术（CABG）和经皮腔内冠状动脉 血管成形术（PTCA）。 种族差异已经被发现， 不同设计研究的一致性。 还剩哪些尚待 然而，要解决的问题是-为什么存在这些差异？ 本提案概述了一项旨在解决这一问题的研究。 的 研究有四个具体目标：1）确定患者和提供者 不包括预测黑白色的皮肤学特征 冠状动脉造影转诊的差异; 2）确定， 转诊进行冠状动脉造影的患者，患者和 提供商特征，用于预测收据中的黑白差异 冠状动脉造影; 3）确定患者和提供者 不包括预测黑白色的皮肤学特征 CABG和PTCA转诊的差异; 4）确定患者 接受CABG或PTCA的患者，患者和提供者 预测接受CABG的黑人-白人差异的特征 和PTCA。

Cardiovascular disease is the leading cause of death among adults in the United States. Although not long ago it was widely believed that African-Americans had a lower incidence of cardiovascular disease than whites, few now believe this to be the case. However, despite parity in the incidence of cardiovascular disease, there remains a substantial Black-White difference in the utilization of tertiary care cardiovascular services (TCCS), such as coronary angiography (CA), coronary bypass surgery (CABG) and percutaneous transluminal coronary angioplasty (PTCA). Race differences have been found with great consistency across studies of varying design. What remains to be addressed, however, is the question - why do these disparities exist? This proposal outlines a study designed to address that question. The study has four specific aims: 1) to determine the patient and provider characteristics exclusive of symptomatology that predict black-white differences in referral for coronary angiography; 2) to determine, for patients who are referred for coronary angiography, the patient and provider characteristics that predict black-white differences in receipt of coronary angiography; 3) to determine the patient and provider characteristics exclusive of symptomatology that predict black-white difference in referral for CABG and PTCA; 4) to determine, for patients who are referred for CABG or PTCA, the patient and provider characteristics that predict black-white differences in receipt of CABG and PTCA.