CONTINUING DIFFERENCES IN THE RATES OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY AND CORONARY-ARTERY BYPASS GRAFT-SURGERY BETWEEN ELDERLY BLACK-AND-WHITE MEDICARE BENEFICIARIES

Rates of hospitalization among black and white male and female Medicar e beneficiaries, 65 years of age and older, for percutaneous translumi nal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG ) surgery and 30-day postadmission mortality rates were compared for t he years 1986 through 1990. The age-adjusted rates of hospitalization for both procedures increased, and the 30-day postadmission mortality rates decreased in all four race-sex groups. The greatest increases in the procedure rates were seen among white males. Using two estimates of the prevalence of ischemic heart disease in the elderly to adjust f or the need for these cardiac procedures, the 1990 rates of PTCA in wh ite beneficiaries were between 1.55 and 1.99 times higher than the rat es among black beneficiaries, and the rates of CABG surgery were betwe en 1.68 and 2.16 times higher. These differences in revascularization rates raise questions about whether there is equal access to certain t reatments in the two race groups.