Heart attack care regionalization may not help minorities, study finds

Although recent protocols have aimed to improve the care standard for severe heart attack patients, people living in minority communities aren't benefiting much as much as those in  non-minority communities, according to a recent study published in JAMA Network Open.

Researchers evaluated whether cardiac care regionalization in California was associated with widened or narrowed disparities in access, treatment and outcomes for severe heart attack patients living in minority and non-minority communities. The study included 139,494 severe heart attack patients between Jan. 1, 2006, and Oct. 31, 2015.

Overall, white patients in non-minority communities experienced the largest care improvements, the study found. Access to hospitals capable of percutaneous coronary intervention, or angioplasty, improved 6.3 percent for patients in non-minority communities and 4.5 percent for minority community patients; non-minority communities saw a 5.1 percent increase in same-day PCI, while a 1.7 percent improvement occurred for minority community patients; and PCI at any time during hospitalization increased 5 percent for patients in non-minority communities and by just 0.7 percent for those in minority communities. Additionally, only white patients from non-minority communities experienced mortality improvement from regionalization. 

"Regionalization was an attempt to equalize access to the gold standard of care for severe heart attack patients, but our research shows that inequalities have been exacerbated, not alleviated," Renee Hsia, MD, study author, told the University of San Francisco's news site. 

The study defined minority communities as those within the top third of ZIP codes with the highest percentages of Black and Hispanic residents. 

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