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February 2, 1999Annals of Internal Medicine

Underuse of Cardiac Procedures: Do Women, Ethnic Minorities, and the Uninsured Fail To Receive Needed Revascularization?

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Why the study?

Are there disparities by sex, ethnicity, payer status, or hospital capabilities in the receipt of necessary revascularization among patients meeting criteria?

Population

631 patients who had coronary angiography in 1992 and met the RAND expert panel criteria for necessary…

Design

Cohort

Authors

LLLucian L. Leape

Discussion

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Overview

Indicated revascularization remains underused without demographic disparities; hospital capabilities may drive use and merit prospective study.

Structured PICO

Are there disparities by sex, ethnicity, payer status, or hospital capabilities in the receipt of necessary revascularization among patients meeting criteria?

P
Population
631 patients who had coronary angiography in 1992 and met the RAND expert panel criteria for necessary revascularization, across 13 hospitals in New York City.
O
Outcome
Receipt of necessary coronary artery bypass graft (CABG) surgery and percutaneous transluminal coronary angioplasty (PTCA)

While revascularization procedures are underused overall, disparities in receipt of necessary care appear driven by hospital capabilities (lack of on-site revascularization) rather than patient demographics.

Cite This Study

Lucian L. Leape (1999) studied this question.

synapsesocial.com/papers/6a898ac11fb56efa37d458e5https://doi.org/10.7326/0003-4819-130-3-199902020-00003
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Race and Gender Disparities in Rates of Cardiac Revascularization2003 · 145 citations
  2. 2Racial Differences in Cardiac Revascularization Rates: Does “Overuse” Explain Higher Rates among White Patients?2001 · 155 citations
  3. 3Racial Differences in the Use of Invasive Cardiovascular Procedures: Review of the Literature and Prescription for Future Research2001 · 409 citations
  4. 4The consequences of under-use of coronary revascularization. Results of a cohort study in Northern Italy2001 · 28 citations
  5. 5Access to Coronary Artery Bypass Surgery by Race/Ethnicity and Gender Among Patients Who Are Appropriate for Surgery1999 · 285 citations