Reducing Racial Disparities In Coronary Angiography

• Published in: Health Affairs Vol. 28; no. 5; pp. 1521 - 1531
• Main Authors: Cantor, Joel C, DeLia, Derek, Tiedemann, Amy, Stanley, Ava, Kronebusch, Karl
• Format: Journal Article
• Language: English
• Published: United States Health Affairs 01-09-2009; The People to People Health Foundation, Inc., Project HOPE
• Subjects: Black or African American - statistics & numerical data; Cardiac Care Facilities - standards; Cardiac Care Facilities - statistics & numerical data; Certificate of Need; Coronary Angiography - standards; Government Regulation; Health care access; Health care policy; Health Care Reform; Healthcare Disparities; Heart surgery; Hospital costs; Hospitals; Hospitals - standards; Hospitals - statistics & numerical data; Humans; Inequality; Licenses; Licensure; Medical imaging; New Jersey; Patients; Pilot projects; Race; Racial differences; Racial discrimination; Regulatory reform; State Government; States; Studies; Trends; White People - statistics & numerical data; New Jersey; United States > US
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.28.5.1521

Racial disparities in cardiac services are well documented; however, policies to close these gaps have not been studied. This paper evaluates a New Jersey certificate-of-need reform to reduce disparities in diagnostic coronary angiography. The number of angiography facilities in New Jersey doubled following reform, and a large black-white disparity was eliminated-a trend not observed in nearby states. Surprisingly, increases in service to African American patients following reform were concentrated in hospitals licensed before reform, while the newly licensed facilities contributed relatively little to reducing disparities. We hypothesize that added hospital competition contributed to the reduction in disparities.