Hannan E L, Kilburn H, O'Donnell J F, Lukacik G, Shields E P
Department of Health Care Policy & Management, School of Public Health, State University of New York, Albany.
Med Care. 1991 May;29(5):430-41. doi: 10.1097/00005650-199105000-00004.
This study examines black/white differences in the utilization of three cardiac procedures (coronary angiography, coronary artery bypass graft, and coronary angioplasty) for patients hospitalized with coronary artery disease in New York State in the first 6 months of 1987. In contrast with previous studies, disease stages are used to control for severity of illness in addition to various severity proxies. Another methodological difference is that patient episodes (a fixed period of time after an initial hospital admission) are used as the unit of analysis rather than discharges to accurately account for patients whose initial visit is to a hospital not certified to perform the procedure. After controlling for severity using logistic regression analysis, whites were found to undergo significantly more of each of the procedures than blacks (odds ratios of 1.25, 2.06, and 1.69 for angiography, bypass graft, and angioplasty, respectively). These significant differences existed for most levels of the various control variables.
本研究调查了1987年上半年纽约州因冠状动脉疾病住院的患者在接受三种心脏手术（冠状动脉造影、冠状动脉搭桥术和冠状动脉成形术）方面的黑白差异。与以往研究不同的是，除了各种病情严重程度替代指标外，还使用疾病阶段来控制疾病的严重程度。另一个方法上的差异是，将患者病程（首次住院后的固定时间段）用作分析单位，而不是出院情况，以便准确统计那些首次就诊医院未获认证进行该手术的患者。在使用逻辑回归分析控制病情严重程度后，发现白人接受每种手术的比例均显著高于黑人（冠状动脉造影、搭桥术和成形术的优势比分别为1.25、2.06和1.69）。在各种控制变量的大多数水平上，这些显著差异均存在。
