+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Sex and Race/Ethnicity-Related Disparities in Care and Outcomes After Hospitalization for Coronary Artery Disease Among Older Adults



Sex and Race/Ethnicity-Related Disparities in Care and Outcomes After Hospitalization for Coronary Artery Disease Among Older Adults



Circulation. Cardiovascular Quality and Outcomes 9(2 Suppl 1): S36-S44



It is unclear to what extent cardiovascular health disparities exist and can be modified among sexes, racial/ethnic groups, and geographic regions in US hospitals. We conducted a cohort study of 49 358 patients aged 65 years and older, admitted to 366 US hospitals from 2003 to 2009 as part of the Get With The Guidelines--Coronary Artery Disease registry linked with Medicare inpatient data. We examined mortality disparities of sex, race/ethnicity, and geographic region with 3-year mortality. The mediator was defined as receiving optimal quality of care. Logistic regression with generalized estimating equations and mediation analysis were used. Compared with men, women were less likely to receive optimal care (odds ratio=0.92; 95% confidence interval: 0.88-0.95; P<0.0001) and more likely to have higher mortality if they received suboptimal care (odds ratio=1.25; 95% confidence interval: 1.00-1.55; P=0.05, P for interaction=0.04). Approximately 69% of the sex disparity may potentially be reduced by providing optimal quality of care to women. Quality of care did not differ across racial/ethnic groups or geographic regions. Blacks were more likely to die than whites (odds ratio=1.33; 95% confidence interval: 1.21-1.46; P<0.0001), and this disparity persisted regardless of the quality of care received. Women were less likely than men to receive optimal care at discharge. The observed sex disparity in mortality could potentially be reduced by providing equitable and optimal care. In contrast, the higher mortality observed in black patients could not be accounted for by differences in the quality of care measured in this study.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058839625

Download citation: RISBibTeXText

PMID: 26908858

DOI: 10.1161/circoutcomes.115.002621


Related references

Disparities in utilization of coronary artery disease treatment by gender, race, and ethnicity: opportunities for prevention. Journal of National Black Nurses' Association 18(1): 36-49, 2007

Health Disparities and Delayed Health care among Older Adults in California: A Perspective from Race, Ethnicity, and Immigration. Public Health Nursing 33(5): 383-394, 2017

Disparities in Health Care Utilization of Adults With Traumatic Brain Injuries Are Related to Insurance, Race, and Ethnicity: A Systematic Review. Journal of Head Trauma Rehabilitation 33(3): E40-E50, 2017

Associations of Race and Ethnicity With Patient-Reported Outcomes and Health Care Utilization Among Older Adults Initiating a New Episode of Care for Back Pain. Spine 43(14): 1007-1017, 2017

Disparities in utilization of outpatient rehabilitative care following hip fracture hospitalization with respect to race and ethnicity. Archives of Physical Medicine and Rehabilitation 90(4): 560-563, 2009

Disparities among older adults in measures of cognitive function by race or ethnicity. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 60(5): P242-P250, 2005

Disparities in race/ethnicity and gender in in-hospital mortality rates for coronary artery bypass surgery patients. Journal of the National Medical Association 98(11): 1729-1739, 2006

Sex-related disparities in obstructive coronary artery disease, percutaneous coronary intervention, and mortality in adults with cardiac arrest. International Journal of Cardiology 269: 23-26, 2018

Heart Age, Cardiovascular Disease Risk, and Disparities by Sex and Race/Ethnicity Among New York City Adults. Public Health Reports 2019: 33354919849881, 2019

Medication use, emergency hospital care utilization, and quality-of-life outcome disparities by race/ethnicity among adults with asthma. American Journal of Managed Care 16(11): 821-828, 2011

Health & access to care among working-age lower income adults in the Great Recession: Disparities across race and ethnicity and geospatial factors. Social Science and Medicine 182: 30-44, 2017

Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults. Gerontologist 57(Suppl 1): S30-S39, 2017

The role of race and ethnicity in predicting length of hospice care among older adults. Journal of Palliative Medicine 15(2): 149-153, 2012

Race/Ethnicity-Specific Disparities in the Severity of Disease at Presentation in Adults with Ulcerative Colitis: A Cross-Sectional Study. Digestive Diseases and Sciences 62(10): 2876-2881, 2017

The impact of a standardized disease management program on race/ethnicity and gender disparities in care and mortality. Journal of Health Care for the Poor and Underserved 21(1): 264-276, 2010