التفاصيل البيبلوغرافية
| العنوان: |
Racial and Ethnic Differences in Time to Acute Reperfusion Therapy for Patients Hospitalized With Myocardial Infarction. |
| المؤلفون: |
Bradley, Elizabeth H., Herrin, Jeph, Wang, Yongfei, McNamara, Robert L., Webster, Tashonna R., Magid, David J., Blaney, Martha, Peterson, Eric D., Canto, John G., Pollack,, Charles V., Krumholz, Harlan M. |
| المصدر: |
JAMA: Journal of the American Medical Association; 10/6/2004, Vol. 292 Issue 13, p1563-1572, 10p |
| مصطلحات موضوعية: |
MEDICAL care of African Americans, DISCRIMINATION in medical care, RACE discrimination, MEDICAL care, MEDICAL care of Hispanic Americans, MEDICAL care of minorities |
| مصطلحات جغرافية: |
UNITED States |
| مستخلص: |
Context Nonwhite patients experience significantly longer times to fibrinolytic therapy (door-to-drug times) and percutaneous coronary intervention (door-to-balloon times) than white patients, raising concerns of health care disparities, but the reasons for these patterns are poorly understood. Objectives To estimate race/ethnicity differences in door-to-drug and door-to-balloon times for patients receiving primary reperfusion for ST-segment elevation myocardial infarction; to examine how sociodemographic factors, insurance status, clinical characteristics, and hospital features mediate racial/ethnic differences. Design, Setting, and Patients Retrospective, observational study using admission and treatment data from the National Registry of Myocardial Infarction (NRMI) for a US cohort of patients with ST-segment elevation myocardial infarction or left bundle-branch block and receiving reperfusion therapy. Patients (73,032 receiving fibrinolytic therapy; 37,143 receiving primary percutaneous coronary intervention) were admitted from January 1, 1999, through December 31, 2002, to hospitals participating in NRMI 3 and 4. Main Outcome Measure Minutes between hospital arrival and acute reperfusion therapy. Results Door-to-drug times were significantly longer for patients identified as African American/black (41.1 minutes), Hispanic (36.1 minutes), and Asian/Pacific Islander (37.4 minutes), compared with patients identified as white (33.8 minutes) (P<.01 for all). Door-to-balloon times for patients identified as African American/black (122.3 minutes) or Hispanic (114.8 minutes) were significantly longer than for patients identified as white (103.4 minutes) (P<.001 for both). Racial/ethnic differences were still significant but were substantially reduced after accounting for differences in mean times to treatment for the hospitals in which patients were treated; significant racial/ethnic differences persisted after further adjustment for sociodemographic characte... [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
