RT Journal
A1 Osborne NH, Mathur AK, Upchurch GR, Jr, Dimick JB
T1 UNderstanding the racial disparity in the receipt of endovascular abdominal aortic aneurysm repair
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD November 15
VO 145
IS 11
SP 1105
OP 1108
DO 10.1001/archsurg.2010.213
UL http://dx.doi.org/10.1001/archsurg.2010.213
AB Hypothesis 
    Racial disparity exists in the management of abdominal aortic aneurysms (AAAs) using new health care technology.Design 
    Retrospective cross-sectional study.Setting 
    Medicare database (January 1, 2001, to December 31, 2006).Patients 
    All patients who underwent open or endovascular AAA repair were identified (N = 160 785).Main Outcomes Measures 
    The relationship between race and the type of AAA repair (open vs endovascular), controlling for differences in patient factors and adjusting for the hospitals where patients received care.Results 
    Accounting for differences in patient comorbidities and neighborhood socioeconomic status, black patients were 33% less likely than nonblack patients to undergo endovascular AAA repair (odds ratio, 0.67; 95% confidence interval, 0.63-0.71). Black patients treated in hospitals with the highest proportions of black patients having AAA repair underwent endovascular AAA repair less often than black patients treated in hospitals with the lowest proportions of black patients having AAA repair (31.0% vs 39.6%, P < .05). Accounting for differences in the hospitals where they received care, black patients continued to have a significantly lower rate of endovascular AAA repair (odds ratio, 0.73; 95% confidence interval, 0.67-0.78).Conclusions 
    Despite controlling for differences in patient characteristics and the hospitals where they received care, black patients were still less likely to undergo endovascular AAA repair. Efforts aimed at improving this disparity will need to explore the causes of these treatment differences.