Black and Hispanic Communities Benefit Less from Regionalized Heart Attack Care Protocols, Study Finds

Blacks and Hispanics receive less care from regionalized protocols aimed to deliver heart treatment to severe heart attack patients, according to study published in JAMA Network Open.

“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,” said Renee Hsia, MD, MSc, professor in the Department of Emergency Medicine at UCSF and lead author of the study, via a press release.

To conduct this study, researchers assessed data on 139,494 patients who suffered the most severe type of heart attack, and compared changes over time in outcomes during the study period beginning in 2006, when only eight California counties were regionalized for heart attack care, to 2015, when all counties were participating. They defined minority communities as the top third of ZIP codes with the highest percentages of Black and Hispanic residents.

According to the results, with regionalization, access to PCI-capable hospitals improved by just over 6% for all patients in non-minority communities, but only 4.5% percent for patients in minority communities. Moreover, the results showed that same-day PCI increased by just over 5% for patients in non-minority communities, but only by 1.7% percent for individuals in minority communities.

 

“Given that both emergency care in general and PCI specifically are less available in underserved communities, PCI hospitals in minority communities could already be burdened by a high volume of patients as the result of regionalization, and less able to provide guideline-directed care,” said the researchers.

According to Dr. Hsia, “Medical advances do not necessarily benefit all groups equally, and the structure of our health care system may affect how benefits accrue.”