Race and Cardiac Catheterization Use in the Setting of Acute Myocardial Infarction Progress Report. Inclusive Dates: 09/30/09 - 11/30/11.

摘要

This dissertation examined three aspects of racial differences in the use of cardiovascular procedures among patients hospitalized with acute myocardial infarction. First, it assessed the agreement between patient-reported race and ethnicity and race and ethnicity data (medical record, administrative data) collected during the course of hospitalization for acute myocardial infarction, including the association between different definitions of patient race and ethnicity (patient, medical record, administrative data) and treatment and outcomes in patients hospitalized with acute myocardial infarction. Second, it examined racial differences in use of cardiac catheterization in patients undergoing cardiac catheterization post myocardial infarction to determine whether racial variations in use of cardiac catheterization reflect undertreatment of black patients, overtreatment of white patients, or a combination of factors. Third, it evaluated racial differences in the utilization of drug eluting stents among patients undergoing percutaneous coronary intervention in order to assess the diffusion of a new cardiac care technology following its introduction, further determining whether observed racial differences in DES use reflect differences in treatment arise from differential treatment of patients (within-hospital) or due to lower rates of DES use at hospitals disproportionately treating black patients (between-hospital).