Changes in racial disparities in access to coronary artery bypass grafting surgery between the late 1990s and early...

Area of Science:

• Cardiovascular Surgery
• Health Disparities Research
• Health Services Research

Background:

• Persistent racial disparities exist in US medical care, particularly for African American patients.
• Minority patients have lower utilization rates for coronary artery bypass graft surgery (CABG).
• Black patients often receive care from surgeons with poorer performance records compared to white patients.

Purpose of the Study:

• To examine the persistence of disparities in CABG care, including surgical access and access to high-quality surgeons.
• To investigate potential causes for the observed decline in these disparities in recent years.

Main Methods:

• Retrospective analysis of Medicare inpatient and physician claims and New York State Cardiac Surgery Reports.
• Comparison of CABG access and surgeon quality for white and Black patients between two periods: 1997-1999 and 2001-2003.
• Measurement of patient numbers by race and surgeon quality using risk-adjusted mortality rates.

Main Results:

• Disparities in CABG care between white and Black patients have declined between the late 1990s and early 2000s.
• The decline in disparities appears linked to increased surgical capacity among all surgeons.
• Gaps in overall access to CABG surgery between racial groups still remain.

Conclusions:

• While disparities in CABG care have decreased, they have not been entirely eliminated.
• Increased surgical capacity may have contributed to reduced disparities in accessing high-quality surgeons.
• Further efforts are needed to address remaining barriers to equitable access to CABG surgery.