Differences in Utilization of Drug-Eluting Stents by Race and Payer

Edward L. Hannan, Michael Racz, Gary D Walford, Luther T. Clark, David R. Holmes, Spencer B. King, Samin Sharma

Research output: Contribution to journalArticle

Abstract

Numerous disparities in access to health care by race and gender have been identified in the literature. This study examines differences in the use of drug-eluting stents (DES) versus bare-metal stents (BMS) by race, payer, and income level. Data from New York State's Percutaneous Coronary Intervention Reporting System from July 2003 to December 2004 were used to examine use of DES (20,165 patients) relative to BMS (4,547 patients) by race, payer, and annual income level, controlling for a variety of patient and hospital characteristics. African-Americans were found to be less likely to receive DES than other races between July 2003 and March 2004 (adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.50 to 0.65) and between April 2004 and December 2004 (adjusted OR 0.74, 95% CI 0.61 to 0.90). These disparities were reduced (respective adjusted ORs 0.67, 95% CI 0.58 to 0.77 and 0.81, 95% CI 0.66 to 0.91) when controlling for admitting hospital and hospital volume, but were still significant. Medicaid/self-pay patients, and patients living in zip codes with median annual incomes between $20,000 and $30,000 were also less likely to receive DES in the first time period (adjusted respective ORs 0.80, 95% CI 0.68 to 0.93) and 0.85, 95% CI 0.75 to 0.96). In conclusion, African-Americans and low income groups receive DES less frequently than their counterparts compared with BMS. This is related to the hospitals where they are admitted, but not entirely.

Original languageEnglish (US)
Pages (from-to)1192-1198
Number of pages7
JournalThe American Journal of Cardiology
Volume100
Issue number8
DOIs
StatePublished - Oct 15 2007
Externally publishedYes

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Drug-Eluting Stents
Confidence Intervals
Stents
Metals
African Americans
Odds Ratio
Health Services Accessibility
Medicaid
Percutaneous Coronary Intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hannan, E. L., Racz, M., Walford, G. D., Clark, L. T., Holmes, D. R., King, S. B., & Sharma, S. (2007). Differences in Utilization of Drug-Eluting Stents by Race and Payer. The American Journal of Cardiology, 100(8), 1192-1198. https://doi.org/10.1016/j.amjcard.2007.05.039

Differences in Utilization of Drug-Eluting Stents by Race and Payer. / Hannan, Edward L.; Racz, Michael; Walford, Gary D; Clark, Luther T.; Holmes, David R.; King, Spencer B.; Sharma, Samin.

In: The American Journal of Cardiology, Vol. 100, No. 8, 15.10.2007, p. 1192-1198.

Research output: Contribution to journalArticle

Hannan, EL, Racz, M, Walford, GD, Clark, LT, Holmes, DR, King, SB & Sharma, S 2007, 'Differences in Utilization of Drug-Eluting Stents by Race and Payer', The American Journal of Cardiology, vol. 100, no. 8, pp. 1192-1198. https://doi.org/10.1016/j.amjcard.2007.05.039
Hannan, Edward L. ; Racz, Michael ; Walford, Gary D ; Clark, Luther T. ; Holmes, David R. ; King, Spencer B. ; Sharma, Samin. / Differences in Utilization of Drug-Eluting Stents by Race and Payer. In: The American Journal of Cardiology. 2007 ; Vol. 100, No. 8. pp. 1192-1198.
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