Patient race is a determining factor in receiving a referral for coronary angiography, according to a recent study from the Johns Hopkins Bloomberg School of Public Health, St. Agnes Healthcare, and Bon Secours Baltimore Health System. However, once patients receive a referral, there is no significant difference in receiving the procedure when comparing white and black patients.

Coronary angiography is a very common invasive diagnostic procedure and precursor to life-saving open heart surgery. A small tube, called a catheter, is passed through a vein in a patient's leg and into the blood vessels around the heart. After an image-enhancing substance is injected into the area, x-rays are taken to obtain images of the functioning of the heart's blood vessels. "Physician Referral Patterns and Race Differences in Receipt of Coronary Angiography" was published in the August 2002 issue of the journal Health Services Research. The study found that African-American patients were 71 percent as likely as white patients to obtain a referral for coronary angiography and 63 percent as likely to receive the procedure. White patients were more likely to be privately insured and less likely to have Medicare, Medicaid, or be uninsured. Analysis shows that patients who have private health insurance are more likely than uninsured patients to receive a referral.

Thomas A LaVeist, PhD, a study co-author and associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health said, "We know from many previous studies that somewhere in the process of getting patients the heart surgery they need, African-American and white patients are ending up with different degrees of access. However, we don't know exactly how or why that's happening. It could be patient choice, doctor's decision making, or something else. This study provides further evidence suggesting that patient preference is probably not what's driving the race disparity in he
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Contact: Kenna Brigham
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
19-Sep-2002

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