Abstract 21615: Disparities in Access to Revascularization After Acute Myocardial Infarction (MI) Before and After the 2002 IOM Report

The Institute of Medicine (IOM) report published in 2002 showed that Blacks were less likely to receive coronary revascularization such as CABG and stents even after controlling for insurance, income and age. It recommended that increased awareness of disparities among health professionals is needed to reduce this.We hypothesized that increased awareness of ethnic disparities since this report would have translated to reduction in disparities in coronary revascularization. Methods: A retrospective analysis was conducted using data from the AHRQ9s National Inpatient Sample (NIS) 1998–2007(10 years). All patients with acute myocardial infarction during this period were identified. The proportion that received percutaneous intervention (PCI) during the incident admission was compared in different ethnicities over the time period. Multivariate regression for each year was conducted using Poisson regression with robust variances to account for the relatively high rates of revascularizations. The analysis controlled for gender, insurance status, co-morbidities and hospital characteristics. Results: Based on the database, about 2.04 million patients were managed for acute MI from 1998–2007. The primary revascularization rate during the incident admission among Whites was 23%, Blacks−17.6% and Hispanics−21.4% [P Conclusions: Ethnic disparities in coronary revascularization persist despite the 2002 IOM report. More definitive measures need to be effected to reduce these disparities.