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Previous Volume 344:1443-1449 May 10, 2001 Number 19 Next

	Full Text PDF Editorial by Epstein, A. M. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Several studies have reported that black patients are less likely than white patients to undergo cardiac catheterization after acute myocardial infarction. The role of the race of the physician in this pattern is unknown.

Methods We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries hospitalized for acute myocardial infarction in 1994 and 1995, to evaluate whether differences between black patients and white patients in the use of cardiac catheterization within 60 days after acute myocardial infarction varied according to the race of their attending physician.

Results Our study cohort consisted of 35,676 white and 4039 black patients with acute myocardial infarction who were treated by 17,550 white and 588 black physicians. Black patients had lower rates of cardiac catheterization than white patients, regardless of whether their attending physician was white (rate of catheterization, 38.4 percent vs. 45.7 percent; P<0.001) or black (38.2 percent vs. 49.6 percent, P<0.001). We did not find a significant interaction between the race of the patients and the race of the physicians in the use of cardiac catheterization. The adjusted mortality rate among black patients was lower than or similar to that among white patients for up to three years after the infarction.

Conclusions Racial differences in the use of cardiac catheterization are similar among patients treated by white physicians and those treated by black physicians, suggesting that this pattern of care is independent of the race of the physician.

Source Information

From the Section of Cardiovascular Medicine, Department of Medicine (J.C., S.S.R., M.J.R., H.M.K.), and the Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health (H.M.K.), Yale University School of Medicine, and the Yale–New Haven Hospital Center for Outcomes Research and Evaluation (M.J.R., Y.W., H.M.K.) — both in New Haven, Conn.; and Qualidigm, Middletown, Conn. (M.J.R., Y.W., H.M.K.).

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