Racial disparity in cardiac procedures and mortality among long-term survivors of XXXX .

@entity1 @entity737 @entity1479 @entity1167
BACKGROUND: It is unknown whether white and black Medicare beneficiaries have different rates of cardiac procedure utilization or long-term survival after @entity1167 . METHODS AND RESULTS: A total of 5948 elderly Medicare beneficiaries (5429 white and 519 black) were identified who survived to hospital discharge between 1990 and 1999 after admission for @entity1167 . Demographic, socioeconomic, and clinical information about these @entity1 was obtained from Medicare administrative files, the US census, and the American Hospital Association's annual institutional survey. A Cox proportional hazard model that included demographic and clinical predictors indicated a hazard ratio for mortality of 1.30 (95% CI 1.09 to 1.55) for blacks aged 66 to 74 years compared with whites of the same age. The addition of cardiac procedures to this model lowered the hazard ratio for blacks to 1.23 (95% CI 1.03 to 1.46). In analyses stratified by race, @entity737 ( @entity737 ) had a mortality hazard ratio of 0.53 (95% CI 0.45 to 0.62) for white @entity1 and 0.50 (95% CI 0.27 to 0.91) for black @entity1 . Logistic regression models that compared procedure rates between races indicated odds ratios for blacks aged 66 to 74 years of 0.58 (95% CI 0.36 to 0.94) to receive an @entity1479 and 0.50 (95% CI 0.34 to 0.75) to receive either revascularization or an @entity1479 . CONCLUSIONS: There is racial disparity in long-term mortality among elderly @entity1167 survivors. Both black and white @entity1 benefited from @entity1479 implantation, but blacks were less likely to undergo this potentially life-saving procedure. Lower rates of cardiac procedures may explain in part the lower survival rates among black @entity1 .
