Reducing racial disparities in coronary angiography

Area of Science:

• Health Services Research
• Cardiovascular Medicine
• Health Policy

Background:

• Racial disparities in cardiovascular services are a persistent issue.
• Policies aimed at reducing these disparities have been understudied.
• Diagnostic coronary angiography access is unequal across racial groups.

Purpose of the Study:

• To evaluate the impact of a New Jersey certificate-of-need reform on racial disparities in diagnostic coronary angiography.
• To determine if policy changes can effectively reduce the black-white gap in cardiac services.

Main Methods:

• Analysis of diagnostic coronary angiography facility data in New Jersey before and after a certificate-of-need reform.
• Comparison of trends in nearby states without similar reforms.
• Examination of service increases among African American patients.

Main Results:

• The number of angiography facilities in New Jersey doubled post-reform.
• A significant black-white disparity in diagnostic coronary angiography was eliminated in New Jersey.
• Service increases for African American patients were mainly at pre-existing hospitals, not new facilities.
• Similar disparity reduction was not observed in neighboring states.

Conclusions:

• New Jersey's certificate-of-need reform was associated with the elimination of racial disparities in diagnostic coronary angiography.
• Increased hospital competition, potentially spurred by the reform, is hypothesized as the driver for reduced disparities.
• Targeted policy interventions can impact health equity in cardiac care.