Women, Minorities Less Likely to Get Best Heart Attack Care

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In the study, the Duke team looked at 2001-2003 data from the U.S. Centers for Medicare and Medicaid Services. During that time period, a total of 399,775 patients over 64 were admitted to hospitals without the resources to perform angioplasty or bypass surgery. Just over one-third of these patients were subsequently transferred to a larger facility where these procedures were performed.

According to the data, younger, white men with less serious heart attacks were more likely to be transferred to the larger hospitals, Berger said.

Women were 16 percent less likely to be transferred compared to men, the study found. Compared to white patients, African-Americans were 31 percent less likely to be transferred, and Hispanics, 47 percent less likely to be transferred. Age was another deciding factor. As age increased, so too did the likelihood that patients would be kept at a community hospital.

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"Our findings underline ongoing concerns about disparity in health care in certain subgroups," Berger said. Teasing out the reasons for these inequities is difficult -- "they could be societal, patient or health care-based," he said.

Societal reasons could include the fact that people from poorer socioeconomic backgrounds have fewer options for transfers, Berger said. Some patients might also refuse to be transferred because they feel more comfortable closer to home, he said. Health-care factors, such as the assumption that older patients are less likely to benefit from more aggressive interventions, might also play a role.

"Further research is required to translate these findings into an improvement of health-care quality," Berger said.

The Duke study is just one of many papers on gender and racial disparities in health care being presented at the Atlanta meeting. According to Dr. Nieca Goldberg, the chief of women's cardiac care at New York City's Lenox Hill Hospital, "some of the sickest patients don't have access to really important care, and we need to evaluate the potential reasons and find the ways to improve care."

More information

For more on spotting and treating a heart attack, head to the National Heart, Lung, and Blood Institute (www.nhlbi.nih.gov ).

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