Basu Jayasree, Mobley Lee R
Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA.
Med Care Res Rev. 2008 Oct;65(5):617-37. doi: 10.1177/1077558708318284. Epub 2008 May 19.
The authors examine trends over 1997-2001 in racial or ethnic disparities in the utilization of three costly, referral-sensitive procedures among the elderly-coronary artery bypass grafting (CABG), percutaneous transluminal coronary angioplasty (PTCA), and hip/joint replacement. Using a multivariate framework, they undertake a simultaneous examination of the relationships between patient, local area context, and health systems on these admission types after comparing them to a control group. This period spans the implementation of the Balanced Budget Act and a major Department of Health and Human Services initiative to reduce disparities in cardiovascular and other diseases. Findings suggest increasing disparities for African Americans relative to Whites in their lower utilization of CABG and PTCA over time, and increasing disparities in the utilization of hip/joint replacement among other races' relative to Whites. The authors find that racial or ethnic disparities in use of referral-sensitive procedures did not narrow over 1997-2001.
作者研究了1997年至2001年期间，老年人在使用三种昂贵的、需转诊的手术（冠状动脉搭桥术（CABG）、经皮腔内冠状动脉成形术（PTCA）和髋关节/关节置换术）方面的种族或民族差异趋势。他们采用多变量框架，在将这些入院类型与对照组进行比较后，同时考察了患者、当地环境和医疗系统之间的关系。这一时期涵盖了《平衡预算法案》的实施以及美国卫生与公众服务部一项旨在减少心血管疾病和其他疾病差异的重大举措。研究结果表明，随着时间的推移，非裔美国人相对于白人在CABG和PTCA使用率较低方面的差异不断增加，其他种族相对于白人在髋关节/关节置换术使用率方面的差异也在增加。作者发现，1997年至2001年期间，在使用需转诊的手术方面，种族或民族差异并未缩小。
