Department of Radiology
University of Wisconsin School of Medicine and Public Health

Elixhauser 2002

 

Year: 2002

Title: Differences between Hispanics and non-Hispanic Whites in use of hospital procedures for cerebrovascular disease

Country: United States

Age: Adult Only

Sex: All Sexes

Population: Hispanic

Care Setting: Inpatient General Care

Clinical Setting: Stroke Imaging

Data Level: Multi-Institution

Data Type: EHR

Data Source: State inpatient databases

Conclusion: Disparities In All Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Hispanics had higher rates of non-invasive diagnostic procedures (CT, ultrasound, echocardiogram, and MRI), but lower rates of invasive diagnostic imaging. The disparities were eliminated or reduced when controlling for the concentration of Hispanic patients in a hospital.

Abstract: OBJECTIVE: This study examined disparities in the use of in-hospital diagnostic and therapeutic procedures for Hispanics with cerebrovascular disease compared to their non-Hispanic White counterparts. DESIGN: This is a cross-sectional study using 1996 hospital administrative data. METHODS: Hispanics and non-Hispanic Whites with diagnosis codes indicating occlusion or stenosis of precerebral arteries or transient cerebral ischemia were included, with a total of 18,674 New York patients (5.1% Hispanic) and 22,624 California patients (11.1% Hispanic). Adjusted odds ratios compared Hispanics with non-Hispanic Whites for six diagnostic and therapeutic procedures for cerebrovascular disease, controlling for patient and hospital characteristics. RESULTS: Hispanics had higher rates of non-invasive diagnostic procedures (head CT scan, head/neck diagnostic ultrasound, echocardiogram, and head MRI). The odds of invasive diagnostic testing (cerebral arteriogram) and therapeutic procedures (carotid endarterectomy) were lower for Hispanics. Most findings remained unchanged in logistic regression models with patient and hospital characteristics. Adding a measure of the concentration of Hispanic patients by hospital eliminated or reduced observed differences between Hispanics and Whites. CONCLUSIONS: Controlling for each hospital's experience with Hispanic patients eliminated or reduced the magnitude of the disparities in procedure use, suggesting that the concentration of Hispanic patients in a hospital is associated with different patterns of procedure use.