The study of approximately 110,000 heart attack patients treated in more than 1,000 hospitals across the country revealed that Hispanic or African American patients have a 10 to 20 percent longer time in getting the proper emergency treatment for restoring blood flow to the heart. Time to treatment in heart attacks is very important to patient survival and is an indicator of quality of care used by the Centers for Medicare and Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations.
Further, the longer treatment times among racial and ethnic minority groups are due in large part to the quality of the hospitals in which they are treated.
"The finding has important implications for reducing racial and ethnic disparities," said Elizabeth Bradley, associate professor in the Department of Epidemiology and Public Health at Yale School of Medicine and lead author of the study. "Efforts to increase awareness are important. We also need to focus on elevating the quality of care overall and particularly in those hospitals where many minority patients receive care."
Harlan M. Krumholz, M.D., professor of medicine at Yale and senior author of the study said, "The findings suggest that we may have dual systems of care, in which many minority patients are less likely to receive treatment in the higher quality hospitals. Eliminating disparities might best be achieved by efforts to improve quality at poorer performing hospitals and ensuring that all patients have access to high-quality hospitals."
The study is funded by the National Heart, Lung, and Blood Institute and the Patrick and Catherine Weldon Donaghue Medical Research Foundation.
Other authors on the study included Jeph Herrin, Yongfei Wang, Robert L. McNamara, M.D., Tashonna R.Webster, David J. Magid, M.D., Martha Blaney, Eric D. Peterson, M.D., John G. Canto, M.D., and Charles V. Pollack, Jr., M.D.
Citation: JAMA Volume 292 No. 13 p. 1563 October 6, 2004.
Journal
JAMA