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MORE ON RACE AND BYPASS SURGERY.

Previous reports suggesting that blacks are less likely than whites to undergo coronary-artery bypass graft surgery are confirmed by a study analyzing data from 1986 Medicare reimbursement claims.

The authors calculated the rate of CABGs in persons over age 65 according to race, sex, and geographic region. The national 1986 rate for blacks and whites in this age group was 25.6 per 10,000 people. Northeastern states generally had low rates (for example, 19.3 in Maine), while southern states had the highest (42.7 in Alabama). Montana had the highest rate of any single state (44.2). Among whites, the national CABG rate adjusted for age and sex was 27.1 per 10,000; it was much higher in men than women (40.4 vs. 16.2). The overall rate among blacks was only 7.6 (9.3 for men and 6.4 for women). Nationally, the ratio of white to black CABG rates was 3; in the southeast, this ratio was greater than 6. In whites, but not in blacks, rates of CABG correlated with the number of thoracic surgeons per 100,000 people.

These data demonstrate that the performance of CABG is strongly associated with race, and that physician supply may influence the rate at which CABG is performed in whites.

— THL

Published in Journal Watch General Medicine March 27, 1992

Citation(s):

Goldberg KC et al. Racial and community factors influencing coronary artery bypass graft surgery rates for all 1986 Medicare patients. JAMA 1992 Mar 18 267 1473-1477.

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