RACE AND THE USE OF CARDIOVASCULAR SURGICAL PROCEDURES

心血管疾病是中国成年人死亡的主要原因 美国。虽然不久前人们还普遍认为 非裔美国人的心血管疾病发病率低于 白人，现在几乎没有人相信情况是这样的。然而，尽管存在奇偶性 在心血管疾病的发病率方面，仍有相当大的 三级医疗服务利用中的黑白差异 心血管服务(TCCS)，如冠状动脉造影术(CA)， 冠状动脉搭桥术与经皮冠状动脉腔内成形术 血管成形术(PTCA)。种族差异被发现有很大的 不同设计的研究之间的一致性。剩下的是什么？ 然而，解决的是一个问题--为什么存在这些差异？ 这项提案概述了一项旨在解决这一问题的研究。这个 研究有四个具体目标：1)确定患者和提供者 除了预示黑白的症状外的特征 冠状动脉造影术转诊的差异；2)确定 转介进行冠状动脉造影术的患者，患者和 预测接收中的黑白差异的提供程序特征 冠状动脉造影；3)确定患者和提供者 除了预示黑白的症状外的特征 CABG和PTCA转诊的差异；4)确定，对于患者 谁是CABG或PTCA的转介对象，患者和提供者 预测接受冠状动脉旁路移植术中黑白差异的特征 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.