Ethnicity & disease · 2002
Differences between Hispanics and non-Hispanic Whites in use of hospital procedures for cerebrovascular disease.
Сравнительное исследованиеСтатьяПоддержка правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Elixhauser Anne, Weinick Robin M, Betancourt Joseph R, Andrews Roxanne M
Аннотация
OBJECTIVE: This study examined disparities in the use of in-hospital diagnostic and therapeutic procedures for Hispanics with cerebrovascular disease compared to their non-Hispanic White counterparts.
DESIGN: This is a cross-sectional study using 1996 hospital administrative data.
METHODS: Hispanics and non-Hispanic Whites with diagnosis codes indicating occlusion or stenosis of precerebral arteries or transient cerebral ischemia were included, with a total of 18,674 New York patients (5.1% Hispanic) and 22,624 California patients (11.1% Hispanic). Adjusted odds ratios compared Hispanics with non-Hispanic Whites for six diagnostic and therapeutic procedures for cerebrovascular disease, controlling for patient and hospital characteristics.
RESULTS: Hispanics had higher rates of non-invasive diagnostic procedures (head CT scan, head/neck diagnostic ultrasound, echocardiogram, and head MRI). The odds of invasive diagnostic testing (cerebral arteriogram) and therapeutic procedures (carotid endarterectomy) were lower for Hispanics. Most findings remained unchanged in logistic regression models with patient and hospital characteristics. Adding a measure of the concentration of Hispanic patients by hospital eliminated or reduced observed differences between Hispanics and Whites.
CONCLUSIONS: Controlling for each hospital's experience with Hispanic patients eliminated or reduced the magnitude of the disparities in procedure use, suggesting that the concentration of Hispanic patients in a hospital is associated with different patterns of procedure use.
DESIGN: This is a cross-sectional study using 1996 hospital administrative data.
METHODS: Hispanics and non-Hispanic Whites with diagnosis codes indicating occlusion or stenosis of precerebral arteries or transient cerebral ischemia were included, with a total of 18,674 New York patients (5.1% Hispanic) and 22,624 California patients (11.1% Hispanic). Adjusted odds ratios compared Hispanics with non-Hispanic Whites for six diagnostic and therapeutic procedures for cerebrovascular disease, controlling for patient and hospital characteristics.
RESULTS: Hispanics had higher rates of non-invasive diagnostic procedures (head CT scan, head/neck diagnostic ultrasound, echocardiogram, and head MRI). The odds of invasive diagnostic testing (cerebral arteriogram) and therapeutic procedures (carotid endarterectomy) were lower for Hispanics. Most findings remained unchanged in logistic regression models with patient and hospital characteristics. Adding a measure of the concentration of Hispanic patients by hospital eliminated or reduced observed differences between Hispanics and Whites.
CONCLUSIONS: Controlling for each hospital's experience with Hispanic patients eliminated or reduced the magnitude of the disparities in procedure use, suggesting that the concentration of Hispanic patients in a hospital is associated with different patterns of procedure use.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCerebrovascular DisordersCohort StudiesCross-Sectional StudiesDiagnostic ServicesFemaleHealth Services AccessibilityHealth Services ResearchHispanic or LatinoHospitalsHumansLogistic ModelsMaleMiddle AgedOdds RatioPatient Acceptance of Health CarePractice Patterns, Physicians'ProbabilityTherapeuticsUnited StatesWhite People