Race and Timeliness of Transfer for Revascularization in Patients with Acute Myocardial lnfarction

This article examines the relationship between race and treatment for acute myocardial infarction. Patients with acute myocardial infarction who are admitted to hospitals without revascularization capacities are often transferred to hospitals with revascularization capacities, but little is known about racial disparities during these hospitalizations.

The authors evaluated data from 25,947 White and 2,345 Black Medicare beneficiaries with acute myocardial infarction at hospitals without revascularization. Data came from the 2006 Medicare Provider Analysis and Review. Researchers studied the speed at which patients were transferred to revascularization hospitals and the 30-day mortality rates of revascularization hospitals.

Key Findings:

  • Black patients waited longer for transfer to revascularization hospitals than White patients. The median length of stay before transfer for Black patients was two days as opposed to one day for White patients.
  • Longer waits for Black patients were tied both to intra-and inter-hospital disparities. Within urban hospitals, Black patients waited .24 days longer than White patients to be transferred on average. Urban hospitals with higher percentages of Black patients waited longer to transfer all patients than hospitals with lower percentages of Black patients. These results were not seen in rural hospitals.
  • The 30-day mortality rates of revascularization hospitals did not differ between White and Black patients.

This research suggests that there are substantial disparities in the treatment of White and Black patients in need of revascularization services following acute myocardial infarctions.