Nurseweek/Healthweek|Studies find no ethnic disparities in cardiac care

Studies find no ethnic disparities in cardiac care

Posted 2-15-99

Women and ethnic minorities are just as likely as other patients to get bypass surgery or angioplasty, according to two studies published in the Feb. 2 issue of the Annals of Internal Medicine. Overall, however, only 75 percent of all patients needing bypass surgery or angioplasty receive treatment.

Researchers from the Harvard School of Public Health reviewed patient records from 13 New York hospitals that perform angiography. Of the 631 patients who needed treatment, only 74 percent had bypass or angioplasty, regardless of their sex, ethnicity, or ability to pay. In hospitals where bypass or angiography was available, 76 percent of patients received treatment. In facilities where neither procedure was available, the percentage dropped to 59 percent.

Unfortunately, most of the hospitals without bypass and angiography are public hospitals caring for the uninsured, said Lucian Leape, MD, adjunct professor of health policy at the Harvard School of Public Health. "The study raises a lot of questions about how to care for these people, and it illustrates that the problem is not solved," she said.

Linda LaCharity, PhD, RN, assistant professor of nursing at the University of Cincinnati College of Nursing, who has researched women and disparate cardiac care, urges caution in interpreting the data. "I don’t think the New York experience is typical of most places. We have a way to go, and it is, of course, dangerous to take one study and think that everything is hunky-dory," she said.

In the second study, researchers at Johns Hopkins School of Public Health tracked 5,000 black and white patients with renal disease over a seven-year period. Initially, white patients with chronic renal disease were three times more likely to receive cardiac procedures than black patients. The ethnic disparity narrowed significantly, however, after black study participants obtained comprehensive coverage through Medicare after developing end-stage renal disease. Following the onset of ESRD, whites were only 1.4 times more likely to receive a cardiac procedure.

"This study shows that the U.S. healthcare system is capable of eliminating ethnic disparities in health care under the right circumstances," said senior author Neil R. Powe, MD, MPH, in a written statement. "We need to learn how to make this happen under all circumstances so that all Americans can benefit from healthcare technology."