WASHINGTON (Reuters) – Blacks were far less likely than whites to get specialized procedures after a heart attack and were more likely to die within a year, according to a study showing persistent racial disparities in U.S. medical care.
The study, published on Tuesday in the Journal of the American Medical Association, tracked 1.2 million Medicare patients at least 68 years old treated for a heart attack between January 2000 and June 2005 at 4,627 U.S. hospitals. It found large differences in the way heart attacks are treated in black patients compared to white patients.
Blacks were about 30 percent less likely to get procedures to open blood vessels such as angioplasty or open-heart surgery after a heart attack whether or not the hospital they checked into provided full invasive cardiac services, the study found. Blacks were 22 percent less likely to be transferred from a hospital that did not do such procedures to one that did, it found. And when they were, blacks were 23 percent less likely to get these operations than whites, the researchers said.
In the first month after a heart attack, blacks were 9 percent less likely to die than whites, the researchers said, perhaps because whites were more likely to undergo specialized procedures that sometimes can be fatal. But in the period from a month to a year after the heart attack, blacks were up to 26 percent more likely to die than whites, the study found.
“I wished we knew what’s going on,” lead researcher Dr. Ioana Popescu of the University of Iowa Carver College of Medicine and the VA Medical Center in Iowa City said in a telephone interview. The study was not designed to find the reasons for the disparities. Popescu said racial discrimination could not be ruled out, but other factors may be at play including patient preferences for certain types of procedures and possible overuse of certain aggressive procedures in white patients.
Previous studies also have found differences in the way black and white U.S. patients are treated. This one is a large, nationwide study revealing that racial disparities apparently persist. “Unfortunately we couldn’t find significant progress,” Popescu said.
“The most surprising finding was that even when they (black patients) were transferred from a hospital not providing specialized services to a hospital providing these services, they still were significantly less likely to receive these procedures,” Popescu said.
“It is amazing because you would think that somebody with a heart attack being transferred, the main reason for that transfer is for receiving a procedure,” Popescu added.
Medicare is the U.S. government health insurance program for the elderly and disabled.