ArticleMedical care2005
Hospital-level racial disparities in acute myocardial infarction treatment and outcomes.
Article in Medical care, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 136 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
136 citing papers in PubMed, 2 syntheses or guidelines pooled it, 287 citations in OpenAlex.
- Ethnic disparities in mortality from acute coronary syndromes: a systematic review and meta-analysis.Open heart · 2026Pooled it
- Cardiovascular health disparities: a systematic review of health care interventions.Medical care research and review : MCRR · 2007Pooled it
- Differences in Physicians' Verbal and Nonverbal Communication With Black and White Patients at the End of Life.Journal of pain and symptom management · 2016Trial
- Quality of care and racial disparities in medicare among potential ACOs.Journal of general internal medicine · 2014Trial
- Associations Between Social Drivers of Health and Intervention Reach During Implementation of a Supervised Walking Program.Medical care · 2026Observational
- Patient Race/Ethnicity, Socioeconomic Status, and Acute Myocardial Infarction Mortality: Between-Hospital Versus Within-Hospital Disparities.Medical care · 2026Article
- Racial Differences in Outcomes After Perioperative Myocardial Infarction: A Multicenter Analysis of Noncardiac Surgical Patients.Journal of racial and ethnic health disparities · 2026Article
- Upstream Factors Associated With Hospitalization in Black- and Minority-Serving Hospitals.JAMA network open · 2026Observational
- Association of hospital quality and social determinants of health with short-term surgical outcomes among medicare beneficiary patients undergoing elective cancer surgery.American journal of surgery · 2026Article
- Sources of Variation in Cardiovascular Care Cascades.JAMA health forum · 2026Article
- Trends in sepsis-related mortality due to dermatologic infections in the United States: Demographic and geographic patterns from 1999 to 2023.Journal of public health research · 2026Article
- Income and Geographic Disparities in in-Hospital Mortality Following Cardiovascular Procedures: Evidence From the National Inpatient Sample, 2016-2022.Health services research · 2026Observational
- Differences in prostate cancer treatment receipt and timeliness of treatment between African American/Black and White Iowans.Cancer causes & control : CCC · 2025Article
- Disparities by Race and Ethnicity in Percutaneous Coronary Intervention.JAMA network open · 2025Article
- Race/Ethnic Differences in In-Hospital Mortality after Acute Ischemic Stroke.Cerebrovascular diseases (Basel, Switzerland) · 2025Article
- Hospital Allocation and Racial Disparities in Health Care.The review of economics and statistics · 2024Article
- Race and Ethnicity and Emergency Department Discharge Against Medical Advice.JAMA network open · 2023Article
- Effects of System-Level Factors on Race/Ethnic Differences in In-Hospital Mortality after Acute Ischemic Stroke.medRxiv : the preprint server for health sciences · 2023Article
- Clinically informed machine learning elucidates the shape of hospice racial disparities within hospitals.NPJ digital medicine · 2023Article
- System Failure: The Geographic Distribution of Sepsis-Associated Death in the USA and Factors Contributing to the Mortality Burden of Black Communities.Journal of racial and ethnic health disparities · 2023Article
76 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPrevious studies have documented racial disparities in treatment of acute myocardial infarction (AMI) among Medicare beneficiaries. However, the extent to which unobserved differences between hospitals explains some of these differences is unknown.
objectiveThe objective of this study was to determine whether the observed racial treatment disparities for AMI narrow when analyses account for differences in where blacks and whites are hospitalized. RESEARCH
designRetrospective observational cohort study using Medicare claims and medical record review. SUBJECTS: This study included 130,709 white and 8286 black Medicare patients treated in 4690 hospitals in 50 US states for confirmed AMI in 1994 and 1995. MEASURES: Measures in this study were receipt of reperfusion, aspirin, and smoking cessation counseling during hospitalization; prescription of aspirin, angiotensin-converting enzyme inhibitor, and beta-blocker at hospital discharge; receipt of cardiac catheterization, percutaneous coronary intervention (PCI), or bypass surgery (CABG) within 30 days of AMI; and 30-day and 1-year mortality.
resultsWithin-hospital analyses narrowed or erased black-white disparities for medical treatments received during the acute hospitalization, widened black-white disparities for follow-up surgical treatments, and augmented the survival advantage among blacks. These findings indicate that, on average, blacks went to hospitals that had lower rates of evidence-based medical treatments, higher rates of cardiac procedures, and worse risk-adjusted mortality after AMI.
conclusionsIncorporating the hospital effect altered the findings of racial disparity analyses in AMI and explained more of the disparities than race. A policy of targeted hospital-level interventions may be required for success of national efforts to reduce disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.