University of California, San Diego, Sharp Health Care, San Diego, USA.
Sharp Chula Vista Medical Center, San Diego, California, USA.
Cardiol Res Pract. 2013;2013:975393. doi: 10.1155/2013/975393. Epub 2013 Dec 30.
Background. Disparities in acute myocardial infarction (AMI) care for women and minorities have been extensively reported in United States but with limited information on Hispanics. Methods. Medical records of 287 (62%) Hispanic and 176 (38%) non-Hispanic white (NHW) patients and 245 women (53%) admitted with suspected AMI to a southern California nonprofit community hospital with a large Hispanic patient and provider representation were reviewed. Baseline characteristics, outcomes (mortality, CATH, PCI, CABG, and use of pertinent drug therapy), and medical insurance were analyzed according to gender, Hispanic and NHW race/ethnicity when AMI was confirmed. For categorical variables, 2 × 2 chi-square analysis was conducted. Odds ratio and 95% confidence interval for outcomes adjusted for gender, race/ethnicity, cardiovascular risk factors, and insurance were obtained. Results. Women and Hispanics had similar drug therapy, CATH, PCI, and mortality as men and NHW when AMI was confirmed (n = 387). Hispanics had less private insurance than NHW (31.4% versus 56.3%, P < 0.001); no significant differences were found according to gender. Conclusions. No differences in quality measures and outcomes were found for women and between Hispanic and NHW in AMI patients admitted to a facility with a large Hispanic representation. Disparities in medical insurance showed no influence on these findings.
在美国，女性和少数族裔在急性心肌梗死（AMI）治疗方面的差异已被广泛报道，但关于西班牙裔的信息有限。方法：对 287 名（62%）西班牙裔和 176 名（38%）非西班牙裔白人（NHW）患者的医疗记录进行了回顾，这些患者在加利福尼亚州南部一家非营利性社区医院因疑似 AMI 入院，该医院有大量的西班牙裔患者和医生。根据性别、西班牙裔和 NHW 种族/民族，对基线特征、结局（死亡率、CATH、PCI、CABG 和相关药物治疗的使用）和医疗保险进行了分析，当 AMI 得到确诊时。对于分类变量，进行了 2×2 卡方分析。根据性别、种族/民族、心血管危险因素和保险情况，对结局进行调整后，获得了调整后的结局的比值比和 95%置信区间。结果：当 AMI 得到确诊时（n=387），女性和西班牙裔与男性和 NHW 相比，药物治疗、CATH、PCI 和死亡率相似。西班牙裔的私人医疗保险比例低于 NHW（31.4%比 56.3%，P<0.001）；但性别之间无显著差异。结论：在一家有大量西班牙裔患者的医疗机构中，接受治疗的 AMI 患者中，女性和西班牙裔与 NHW 之间在质量指标和结局方面没有差异。医疗保险方面的差异对这些发现没有影响。
