• Am. J. Med. Sci. · May 1998

    Comparative Study

    Racial differences in cardiac catheterization use and appropriateness.

    • J A Ferguson, T A Adams, and M Weinberger.
    • Center for Health Services Research, Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana 46202, USA. ferguson@hsrd.iupui.edu
    • Am. J. Med. Sci. 1998 May 1; 315 (5): 302306302-6.

    AbstractThe authors sought to investigate the role of medical appropriateness as a potential explanatory factor in previously observed interracial cardiac procedure rate differences. A retrospective cohort study using RAND appropriateness criteria was conducted at a Veterans Affairs medical center among a sample of patients who were evaluated for cardiovascular disease during 1993 (n=200). All participants were men and 50% were black (mean age=61.8 years). Blacks were less likely than whites to undergo cardiac catheterizations (CC) (odds ratio [OR]=0.23, P < 0.01). When RAND criteria were applied, blacks were found to have fewer indications that made them appropriate candidates for CC and more indications making them inappropriate candidates for CC (chi-square test, P < 0.05). No CC procedure underuse was found among blacks, whereas 10% of CC overuse was found among whites. Interracial CC procedure use differences were not due to procedure underuse among blacks but were in part due to overuse among whites.

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