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种族、性别与心血管疾病:当患有缺血性心脏病和心肌梗死的患者就诊时,在以黑人为主的医院中是否存在差异?

Race, gender, and cardiovascular disease: do disparities exist at hospitals that serve majority black populations when patients present with ischemic heart disease and myocardial infarction?

作者信息

Caillier James Gerard

机构信息

Bowie State University, Master of Public Administration Program, USA.

出版信息

J Cult Divers. 2006 Winter;13(4):202-7.

PMID:17338490
Abstract

A retrospective review of data was conducted to determine whether disparities in cardiovascular disease treatment occurred in three public teaching hospitals in Louisiana when patients presented for care with ischemic heart disease (IHD) or acute myocardial infarction (MI). Multinomial logit models were used to estimate the adjusted odds in the utilization of invasive procedures, while controlling for confounders (i.e., age, marital status, comorbidities, payer type, diabetes, and cigarette addiction) simultaneously. No significant racial disparities were found for cardiac catheterization (CC) or Percutaneous Transluminal Coronary Angioplasty (PTCA). However, Blacks had a lower adjusted odds ratio (p < .05) for coronary artery bypass graft surgery (CABG) than did Whites. Furthermore, models failed to show significant gender disparities for invasive procedure utilizations. These disparities, or lack of, may be partially due to patient demographic characteristics or study limitations. Future research should focus on physician referrals and patient preferences.

摘要

对数据进行了回顾性分析,以确定当患者因缺血性心脏病(IHD)或急性心肌梗死(MI)前来路易斯安那州的三家公立教学医院就诊时,心血管疾病治疗方面是否存在差异。使用多项logit模型来估计在控制混杂因素(即年龄、婚姻状况、合并症、付款人类型、糖尿病和吸烟成瘾)的同时,侵入性手术使用的调整后优势比。在心脏导管插入术(CC)或经皮腔内冠状动脉成形术(PTCA)方面未发现明显的种族差异。然而,黑人接受冠状动脉旁路移植手术(CABG)的调整后优势比低于白人(p < 0.05)。此外,模型未显示侵入性手术使用方面存在明显的性别差异。这些差异或不存在差异,可能部分归因于患者的人口统计学特征或研究局限性。未来的研究应关注医生转诊和患者偏好。

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J Cult Divers. 2006 Winter;13(4):202-7.
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