Continuing differences in the rates of percutaneous transluminal coronary angioplasty and coronary artery bypass graft surgery between elderly black and white Medicare beneficiaries

Rates of hospitalization among black and white male and female Medicare beneficiaries, 65 years of age and older, for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG) surgery and 30-day postadmission mortality rates were compared for the years 1986 through 1990. The age-adjusted rates of hospitalization for both procedures increased, and the 30-day postadmission mortality rates decreased in all four race-sex groups. The greatest increases in the procedure rates were seen among white males. Using two estimates of the prevalence of ischemic heart disease in the elderly to adjust for the need for these cardiac procedures, the 1990 rates of PTCA in white beneficiaries were between 1.55 and 1.99 times higher than the rates among black beneficiaries, and the rates of CABG surgery were between 1.68 and 2.16 times higher. These differences in revascularization rates raise questions about whether there is equal access to certain treatments in the two race groups.