MINORITY HEALTH: Blacks Receive Substandard Cardiac Care
In the latest of several recent reports highlighting disparities in medical care given to minority patients, a study published in the journal Circulation found that hospitals often fail to recommend even the least expensive treatments, such as aspirin, to low-income or African-American patients who are discharged after suffering a heart attack, the Raleigh News & Observer reports. The report reviewed the care of 169,079 Medicare patients hospitalized for heart attacks between 1994 and 1996, and found that black patients were 16% less likely than whites to receive anticoagulation medication within the few hours after a heart attack, 3% less likely to receive aspirin upon hospital admission, and 6% less likely to leave the hospital with prescriptions for beta-blocking drugs, despite the fact that this regimen constitutes the standard course of care for heart attack patients. Low-income patients were 2-3% less likely to receive every treatment than those with higher incomes. In addition, women were 2% less likely than men to receive aspirin on arrival or departure, although they received the other medications at the same rate. Dr. Kevin Schulman, a Duke University Medical Center physician who co-authored the report, said that although the percentages are small, cardiovascular disease is such a common cause of death that the disparities in care affect thousands of patients. Rather than reflecting direct racial prejudice, care differences may best be attributed to "system failures" at hospitals, particularly facilities "stressed" with high numbers of low-income patients, Schulman said. He explained, "When you have a system failure, the people who are most affected by it are those who are least able to speak up for themselves -- minorities or poor people." Previously, Schulman co-authored a separate study indicating that medical students were more likely to diagnose correctly a white man's cardiac symptoms than a black woman's (Avery, 8/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.