Previous research has documented substantial race differences in receipt of coronary angiography between Black and White cardiac patients. Differences have been found in bivariate as well as multivariate analyses which control for a variety of factors including clinical characteristics of the patient such as disease severity, income, insurance status, age, sex and type of hospital visited. Yet, in spite of this large literature the reasons for this difference have not yet been determined. The primary reason for this knowledge gap is that previously analyzed data sources to address this question have been inadequate. The present study seeks support to examine a unique data source designed to address the issue of race disparities in access and utilization of coronary angiography. The Cardiac Access Study database is an NHLBI-FUNDED study with comprehensive data on nearly 2,000 cardiac patients who were determined to be appropriate candidates for the coronary angiography. The database includes data from medical records, patient interviews and physician interviews. This project has three specific aims: 1. To determine the patient and provider characteristics, exclusive of symptomatology, that predict race differences in referral for coronary angiography; 2. To determine the barriers that result in race differences in receipt of cardiovascular surgical procedures among patients who have been referred; To determine the factors that predict delay in receipt of cardiovascular surgical procedures among patients who have been referred.
