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dc.contributor.authorGroeneveld, Peter W.
dc.contributor.authorHeidenreich, Paul A.
dc.contributor.authorGarber, Alan M
dc.date.accessioned2014-01-28T22:08:17Z
dc.date.issued2005
dc.identifierQuick submit: 2013-12-20T17:56:08-05:00
dc.identifier.citationGroeneveld, Peter W., Paul A. Heidenreich, and Alan M. Garber. 2005. Trends in implantable cardioverter-defibrillator racial disparity. Journal of the American College of Cardiology 45, 1:72-78.en_US
dc.identifier.issn0735-1097en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11595745
dc.description.abstractObjectives The study was designed to determine whether racial disparity in utilization of the implantable cardioverter-defibrillator (ICD) has improved over time, and whether small-area geographic variation in ICD utilization contributed to national levels of racial disparity. Background Although racial disparities in cardiac procedures have been well-documented, it is unknown whether there has been improvement over time. Low ICD utilization rates in predominantly black geographic areas may have exacerbated national levels of disparity. Methods Discharge abstracts from elderly black and white Medicare beneficiaries hospitalized with ventricular arrhythmias from 1990 to 2000 were analyzed to determine if ICD implantation occurred within 90 days of initial hospitalization. Multivariate logistic regression models were constructed to assess the relationship between ICD implantation, year of admission, and the percentage of black inhabitants in each patient's county of hospitalization while controlling for clinical, hospital, and demographic characteristics. Results There was improvement in ICD implantation racial disparity: In the period 1990 to 1992, black patients had an odds ratio of 0.52 (95% confidence interval [CI] 0.42 to 0.64) for receiving an ICD compared with whites. However, by 1999 to 2000, the odds ratio for blacks had risen to 0.69 (95% CI 0.61 to 0.78) (test-for-trend p = 0.01). Approximately 20% of this trend could be explained by reduction in geographic variation in ICD use between areas with larger black and predominantly white populations. Conclusions Rates of ICD implants became more equal among whites and blacks during the 1990s, although persistent disparity remained at the decade's end. Geographic equalization in cardiovascular procedure rates may be an essential mechanism in rectifying disparities in health care.en_US
dc.language.isoen_USen_US
dc.publisherElsevieren_US
dc.relation.isversionofdoi:10.1016/j.jacc.2004.07.061en_US
dc.relation.isversionofhttp://www.sciencedirect.com/science/article/pii/S0735109704019540en_US
dash.licenseMETA_ONLY
dc.titleTrends in implantable cardioverter-defibrillator racial disparityen_US
dc.typeJournal Articleen_US
dc.date.updated2013-12-20T22:57:28Z
dc.description.versionVersion of Recorden_US
dc.rights.holderGroeneveld PW; Heidenreich PA; Garber AM
dc.relation.journalJournal of the American College of Cardiologyen_US
dash.depositing.authorGarber, Alan M
dash.embargo.until10000-01-01
dc.identifier.doi10.1016/j.jacc.2004.07.061*
workflow.legacycommentsFLAG2: Cannot use publisher's version. Must obtain author's submitted manuscript.en_US
dash.contributor.affiliatedGarber, Alan


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