“Improving Policy Interventions by Understanding Racial and Ethnic Disparities in Access to Advanced Cardiac Treatment,” presented by Charleen Hsuan, JD, PhD

Mortality rates for ST-segment elevation myocardial infarction (STEMI) are higher for Black patients than White patients. Racial and ethnic disparities in percutaneous coronary intervention (PCI), the recommended treatment for STEMI, contribute to higher mortality rates. Understanding when and how these disparities occur is critical in designing policies that improve outcomes for STEMI patients. Using Florida statewide discharge data from 2012 to 2021, potential processes by which disparities in PCI utilization occur were examined. This study found that racial and ethnic disparities in PCI occurred at every stage, and that they could not wholly be explained by insurance or differences between hospitals. This suggests that policies to reduce disparities in PCI utilization should be multi-faceted and target all steps in the process. Examples include within-hospital STEMI treatment protocols to reduce potential subjective bias, inter-hospital transfer agreements, and attention to population health at a policy level to align incentives of stakeholders and patients.

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