Am J Med Sci
The 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.
430, Blacks, Blacks: statistics & numerical data, Cardiovascular Diseases: diagnosis, Cohort Studies, Comparative Study, criteria, differences, Disease, Heart Catheterization: statistics & numerical data: utilization, Human, Male, medical, Middle Age, Odds Ratio, patient, Patient Selection, Patients, Prejudice, ResNet, Retrospective Studies, Role, Support,U.S.Gov't,Non-P.H.S., Whites, Whites: statistics & numerical data