American Journal of Public Health, Vol 90, Issue 11 1774-1777, Copyright © 2000 by American Public Health Association

JOURNAL ARTICLE

Racial differences in access to high-quality cardiac surgeons

DB Mukamel, AS Murthy and DL Weimer
Department of Community and Preventive Medicine, University of Rochester Medical Center, NY 14642, USA. dana_mukamel@urmc.rochester.edu

OBJECTIVES: Racial differences in access to cardiac artery bypass graft (CABG) surgery are well documented. This study extends the literature by examining racial differences in access to high-quality cardiac surgeons. METHODS: The analyses included 11,296 CABG surgeries in New York State in 1996. Regression techniques were used to identify significant associations between a patient's race, health maintenance organization (HMO) enrollment, and the quality of the surgeon performing the surgery, measured by the surgeon's risk-adjusted mortality rate (RAMR). RESULTS: Non-Whites were more likely than Whites to have access to surgeons of higher RAMR, by 11.7% among HMO enrollees (1-tailed P < .1) and by 5.4% among fee-for-service enrollees (1-tailed P < .05). CONCLUSIONS: Even when racial minorities do gain access to CABG services, they are more likely that non-Whites to receive care from lower-quality providers.

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