Lower use of carotid artery imaging at minorita-serving hospitals

Eric M. Cheng, Salomeh Keyhani, Susan Ofner, Linda S. Williams, Paul L. Hebert, Diana L. Ordin, Dawn M. Bravata

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: We determined whether site of care explains a previously identified racial disparita in carotid artery imaging. Methods: In this retrospective cohort study, data were obtained from a chart review of veterans hospitalized with ischemic stroke at 127 Veterans Administration hospitals in 2007. Extensive exclusion criteria were applied to obtain a sample who should have received carotid artery imaging. Minorita-serving hospitals were defined as the top 10% of hospitals ranked by the proportion of stroke patients who were black. Population level multivariate logistic regression models with adjustment for correlation of patients in hospitals were used to calculate predictive probabilities of carotid artery imaging by race and minorita-service hospital status. Bootstrapping was used to obtain 95% confidence intervals (CIs). Results: The sample consisted of 1,534 white patients and 628 black patients. Nearly 40% of all black patients were admitted to 1 of 13 minorita-serving hospitals. No racial disparita in receipt of carotid artery imaging was detected within nonminorita serving hospitals. However, the predicted probabilita of receiving carotid artery imaging for white patients at nonminoritaserving hospitals (89.7%, 95% CI [87.3%, 92.1%]) was significantly higher than both white patients (78.0% [68.3%, 87.8%] and black patients (70.5% [59.3%, 81.6%]) at minoritaserving hospitals. Conclusions: Underuse of carotid artery imaging occurred most often among patients hospitalized at minorita-serving hospitals. Further work is required to explore why site of care is a mechanism for racial disparities in this clinically important diagnostic test.

Original languageEnglish (US)
Pages (from-to)138-144
Number of pages7
JournalNeurology
Volume79
Issue number2
DOIs
StatePublished - Jul 10 2012

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Carotid Arteries
Logistic Models
Stroke
Confidence Intervals
Veterans Hospitals
Imaging
United States Department of Veterans Affairs
Veterans
Routine Diagnostic Tests
Cohort Studies
Retrospective Studies
Population

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Lower use of carotid artery imaging at minorita-serving hospitals. / Cheng, Eric M.; Keyhani, Salomeh; Ofner, Susan; Williams, Linda S.; Hebert, Paul L.; Ordin, Diana L.; Bravata, Dawn M.

In: Neurology, Vol. 79, No. 2, 10.07.2012, p. 138-144.

Research output: Contribution to journalArticle

Cheng EM, Keyhani S, Ofner S, Williams LS, Hebert PL, Ordin DL et al. Lower use of carotid artery imaging at minorita-serving hospitals. Neurology. 2012 Jul 10;79(2):138-144. https://doi.org/10.1212/WNL.0b013e31825f04c5
Cheng, Eric M. ; Keyhani, Salomeh ; Ofner, Susan ; Williams, Linda S. ; Hebert, Paul L. ; Ordin, Diana L. ; Bravata, Dawn M. / Lower use of carotid artery imaging at minorita-serving hospitals. In: Neurology. 2012 ; Vol. 79, No. 2. pp. 138-144.
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