Explaining disparities in access to high-quality cardiac surgeons
The Annals of Thoracic SurgeryPublished 29 June 2004
Barbara M Rothenberg, Thomas A. Pearson, Jack Zwanziger, Dana B. Mukamel
Citations84
SJR quartileQ1
SJR score1.23
SNIP1.38
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Race continues to be associated with treatment by a surgeon with a higher risk-adjusted mortality rate, and efforts to achieve the "Healthy People 2010" goals of eliminating health disparities should address not only access to care, but also access to high-quality care.
Abstract
Efforts to achieve the "Healthy People 2010" goals of eliminating health disparities should address not only access to care, but also access to high-quality care.
Keywords
MedicineHealth Professions
Choice Reviews OnlineUnequal treatment: confronting racial and ethnic disparities in health care
7,044 Citations2003A. L. Nelson
A heating element includes an elongated tubular sheath which confines a resistance wire supported by a thermally conductive electrical insulation material which extends to a position flush with the end surface of the sheath.
New England Journal of MedicineEffects of Race and Income on Mortality and Use of Services among Medicare Beneficiaries
815 Citations1996Marian E. Gornick, Paul W. Eggers +5 more
Race and income have substantial effects on mortality and use of services among Medicare beneficiaries and Adjusting the mortality and utilization rates for differences in income generally reduced the racial differences, but the effect was relatively small.
New England Journal of MedicineRacial Variation in the Use of Coronary-Revascularization Procedures — Are the Differences Real? Do They Matter?
551 Citations1997Eric D. Peterson, Linda K. Shaw +4 more
Blacks with coronary disease were significantly less likely than whites to undergo coronary revascularization, particularly bypass surgery - a difference that could not be explained by the clinical features of their disease.
JAMAInvestigation of the Relationship Between Volume and Mortality for Surgical Procedures Performed in New York State Hospitals
541 Citations1989Edward L. Hannan
An improved measure of physician volume is used to test the combined relationship of hospital and physician volume with in-hospital mortality rates and to explore the existence of threshold volumes that optimally discriminate high- and low-volume providers.
Annals of Internal MedicineRacial Differences in the Use of Invasive Cardiovascular Procedures: Review of the Literature and Prescription for Future Research
407 Citations2001Nancy R. Kressin, Laura A. Petersen
The purpose of this paper is to review the literature examining racial differences in the use of invasive cardiac procedures, to identify gaps in previous research, and to describe promising directions for future research.
Journal of the American College of CardiologyIdentification of preoperative variables needed for risk adjustment of short-term mortality after coronary artery bypass graft surgery
309 Citations1996Robert H. Jones, Edward L. Hannan +6 more
A relatively small number of clinical variables provide a large amount of prognostic information in patients undergoing CABG.
JAMAPredictors of Readmission for Complications of Coronary Artery Bypass Graft Surgery
269 Citations2003Edward L. Hannan
Medical CareQuality of Care Information Makes a Difference
219 Citations1998Dana B. Mukamel, Alvin I. Mushlin
Patients seem to respond to information about quality of individual surgeons and hospitals as expected and the magnitude of the association between reported mortality and market shares varies geographically, potentially reflecting differences in sociodemographic characteristics.
Journal of General Internal MedicineDo Patient Preferences Contribute to Racial Differences in Cardiovascular Procedure Use?
133 Citations1997Jeff Whittle, Joseph Conigliaro +2 more
Race was not a significant predictor of attitudes toward revascularization except for angioplasty recommended by their physician, and preferences were more closely related to questions assessing various aspects of familiarity with the procedure.
Journal of General Internal MedicineDo Patient Preferences Contribute to Racial Differences in Cardiovascular Procedure Use?
116 Citations1997Jeff Whittle, Joseph Conigliaro +2 more
Race was not a significant predictor of attitudes toward revascularization except for angioplasty recommended by their physician, and preferences were more closely related to questions assessing various aspects of familiarity with the procedure.
American Journal of Public HealthThe reliability of racial classifications in hospital discharge abstract data.
110 Citations1994Jan Blustein
Evidence suggests that the misclassification of race in hospital discharge abstract data is nondifferential; racial discrepancies in access to medical services are thus probably even greater than those previously reported.
Journal of the American College of CardiologyThe effect of race on coronary bypass operative mortality
108 Citations2000Charles R. Bridges, Fred H. Edwards +2 more
Black race is an independent predictor of operative mortality after CABG except for very high-risk patients, and patients should be referred for CABGs based on clinical characteristics irrespective of race.
Journal of the American College of CardiologyIdentification of variables needed to risk adjust outcomes of coronary interventions: evidence-based guidelines for efficient data collection
104 Citations1998Peter C. Block, Eric C. Peterson +5 more
The most powerful predictors of adverse outcome were measures of hemodynamic instability, disease severity, demographics and comorbid conditions in both univariate and multivariate analyses.
American Journal of Public HealthRacial differences in access to high-quality cardiac surgeons
101 Citations2000Dana B. Mukamel, A. Murthy +1 more
Even when racial minorities do gain access to CABG services, they are more likely that non-Whites to receive care from lower-quality providers.
Health AffairsRacial Variation In Quality Of Care Among Medicare+Choice Enrollees
89 Citations2002Beth A Virnig, Nicole Lurie +4 more
This paper examines racial variation in quality of and access to care experienced by elderly persons enrolled in Medicare+Choice plans to compare whites with blacks, Asians, Hispanics, and Native Americans to find that black enrollees received lower-quality care.
Medical CareImpact of Patient Socioeconomic Status on Physician Profiles
70 Citations2001Kevin Fiscella, Peter Franks
The results suggest that SES derived from either patient addresses geocoded to the census block group level or zip codes may offer a convenient alternative to individually collected SES when adjusting physician profiles for the socioeconomic characteristics of physicians’ practices.
The Annals of Thoracic SurgeryEffects of race, with or without gender, on operative mortality after coronary artery bypass grafting: a study using The Society of Thoracic Surgeons national database
65 Citations2001Reneé S. Hartz, A. V. Ramana Rao +3 more
Race and gender are independent predictors of adverse outcome following coronary artery bypass grafting, holding all other risk factors constant.
Archives of Internal MedicineAdverse 5-Year Outcome After Coronary Artery Bypass Surgery in Blacks
58 Citations1996Richard J. Gray
In this group of predominantly medically insured patients undergoing coronary artery bypass surgery, the risk of death in blacks at 5 years was twice that of whites and race predicted long-term survival and persisted as an important risk factor after adjusting for preoperative factors related to patient survival.
Journal of the American College of CardiologyChallenges in comparing risk-adjusted bypass surgery mortality results
57 Citations2000Eric D Peterson, Elizabeth R. DeLong +5 more
A hospital's risk-adjusted bypass surgery mortality rating, relative to its peers, was consistent regardless of the risk-adjustment model applied, supporting their use as a means of provider performance feedback.
PubMedDo quality report cards play a role in HMOs' contracting practices? Evidence from New York State.
49 Citations2000Dana B. Mukamel, Alvin I. Mushlin +4 more
Contracting practices for the majority of MCOs do not indicate a systematic selection either for or against surgeons based on their reported mortality scores, and this study suggests that policy initiatives to increase the effective use of report cards should be encouraged.
PubMedCoronary heart disease: black-white differences.
38 Citations1991Rebecca Cooper, Jalal K. Ghali
Important features of the racial patterns in CHD at the present time are summarized in Table 15-10 and there is additional growing evidence that the gains against CHD have been concentrated primarily among the educated and affluent.
