RACIAL ETHNIC-DIFFERENCES IN HEALTH-CARE UTILIZATION OF CARDIOVASCULAR PROCEDURES - A REVIEW OF THE EVIDENCE

Studies based on a variety of primary data sets have consistently demo nstrated that African Americans are about half as likely as whites to receive interventional therapy for coronary artery disease. Neither di sease severity per se nor access to hospitals performing these procedu res accounts for this finding. Likewise, available measures of income and ability to pay, including insurance status, do not explain the dif ferences. Subtle personal factors, including physician bias and the wi llingness of patients to accept referral for surgery, may be important but have not as yet been measured. These findings present a challenge to the presumed equality in access to health care within the United S tates medical system. A new generation of health services research stu dies will be required to provide definitive reasons for this important disparity in treatment.