J. Blustein et Bc. Weitzman, ACCESS TO HOSPITALS WITH HIGH-TECHNOLOGY CARDIAC SERVICES - HOW IS RACE IMPORTANT, American journal of public health, 85(3), 1995, pp. 345-351
Objectives. Relatively few hospitals in the United States offer high-t
echnology cardiac services (cardiac catheterization, bypass surgery, o
r angioplasty). This study examined the association between race and a
dmission to a hospital offering those services. Methods. Records of 11
410 patients admitted With acute myocardial infarction to hospitals i
n New York State in 1986 were analyzed. Results. Approximately one thi
rd of both White and Black patients presented to hospitals offering hi
gh-technology cardiac services. However, in a multivariate model adjus
ting 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 ''d
istance-adjusted'' probabilities reflected three phenomena: (1) patien
ts 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 i
nclude a high-technology hospital, Whites were: more likely than Black
s to travel beyond those nearest hospitals to a high-technology hospit
al. Conclusions. Whites and Blacks present equally to hospitals offeri
ng high-technology cardiac services at the time of acute myocardial in
farction However, there are important underlying racial differences in
geographic proximity and tendencies to travel to those hospitals.