Within‐Physician Differences in Patient Sharing Between Primary Care Physicians and Cardiologists Who Treat White and Black Patients With Heart Disease

Autor: Luke J. Matthews, Cheryl L. Damberg, Shiyuan Zhang, Jose J. Escarce, C. Ben Gibson, Megan Schuler, Ioana Popescu
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 12, Iss 22 (2023)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.123.030653
Popis: Background Black‐White disparities in heart disease treatment may be attributable to differences in physician referral networks. We mapped physician networks for Medicare patients and examined within‐physician Black‐White differences in patient sharing between primary care physicians and cardiologists. Methods and Results Using Medicare fee‐for‐service files for 2016 to 2017, we identified a cohort of Black and White patients with heart disease and the primary care physicians and cardiologists treating them. To ensure the robustness of within‐physician comparisons, we restricted the sample to regional health care markets (ie, hospital referral regions) with at least 10 physicians sharing ≥3 Black and White patients. We used claims to construct 2 race‐specific physician network measures: degree (number of cardiologists with whom a primary care physician shares patients) and transitivity (network tightness). Measures were adjusted for Black‐White differences in physician panel size and calculated for all settings (hospital and office) and for office settings only. Of 306 US hospital referral regions, 226 and 145 met study criteria for all settings and office setting analyses, respectively. Black patients had more cardiology encounters overall (6.9 versus 6.6; P
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