Racial differences in access to high-quality cardiac surgeons.

Area of Science:

• Health Services Research
• Surgical Quality
• Health Equity

Background:

• Racial disparities in access to cardiac artery bypass graft (CABG) surgery are established.
• Previous research has not fully explored racial differences in the quality of cardiac surgeons providing care.

Purpose of the Study:

• To investigate racial disparities in access to high-quality cardiac surgeons for CABG procedures.
• To determine if race influences the quality of surgeons accessed by patients undergoing CABG surgery.

Main Methods:

• Analysis of 11,296 CABG surgeries in New York State from 1996.
• Utilized regression techniques to assess the relationship between patient race, insurance type (HMO vs. fee-for-service), and surgeon quality.
• Surgeon quality was measured by risk-adjusted mortality rate (RAMR).

Main Results:

• Non-White patients were more likely than White patients to be treated by higher RAMR surgeons.
• This disparity was observed in both Health Maintenance Organization (HMO) enrollees (11.7% higher likelihood, P < .1) and fee-for-service enrollees (5.4% higher likelihood, P < .05).

Conclusions:

• Racial minorities undergoing CABG surgery are disproportionately likely to receive care from lower-quality providers, even when they gain access to services.
• These findings highlight significant inequities in the quality of surgical care based on race.