The Effect of Race and Ethnicity on the Use of Selected Health Care Procedures

A Comparison of South Central Los Angeles and the Remainder of Los Angeles County

Published in: Journal of Health Care for the Poor and Underserved, v. 7, no. 4, Nov. 1996, p. 308-322

Posted on RAND.org on November 01, 1996

by David Carlisle, Barbara Leake, Robert H. Brook, Martin F. Shapiro

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The purpose of this study was to compare the use of eight hospital-based procedures (appendectomy, cesarean section, coronary artery angioplasty (PTCA), coronary artery bypass grafting (CABG), carotid endarterectomy, hysterectomy, mastectomy, and transurethral prostate resection) in South Central Los Angeles (SCLA) to the remainder of Los Angeles County. The authors used age- and gender-adjusted procedure rates and population-weighted multivariate regression techniques, adjusting for illness proxies, physician distribution, hospital distance, income, and ethnicity variation to quantitate the effect of SCLA residence. Four procedures were performed at significantly lower rates among residents of SCLA: PTCA, CABG, carotid endarterectomy, and cesarean section. In multivariate regression models, SCLA was also a significant predictor for appendectomy, mastectomy, and transurethral prostatectomy (TURP). The SCLA effect was diminished but not eliminated when ethnicity variables were incorporated into regression models. The use of selected procedures by residents of SCLA frequently differs from that of residents of the remainder of Los Angeles County. Some differences are not attributable to level of health, income, ethnicity, or the availability of medical resources.

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