BACKGROUND: Primary @entity64 centers (PSCs) utilize more recombinant @entity1456 (rt-PA) than non-PSCs. The impact of PSCs on racial disparities in rt-PA use is unknown. METHODS AND RESULTS: We used data from the Nationwide Inpatient Sample from 2004 to 2010, limited to states that publicly reported hospital identity and race. Hospitals certified as PSCs by The Joint Commission were identified. Adults with a diagnosis of @entity385 were analyzed. Rt-PA use was defined by the International Classification of Diseases, 9(th) Revision procedure code 99.10. Discharges (304 152 @entity1 ) from 26 states met eligibility criteria, and of these 71.5% were white, 15.0% black, 7.9% Hispanic, and 5.6% other. Overall, 24.7% of white, 27.4% of black, 16.2% of Hispanic, and 29.8% of other @entity1 presented to PSCs. A higher proportion received rt-PA at PSCs than non-PSCs in all race/ethnic groups (white 7.6% versus 2.6%, black 4.8% versus 2.0%, Hispanic 7.1% versus 2.4%, other 7.2% versus 2.5%, all P<0.001). In a multivariable model adjusting for year, age, sex, insurance, medical comorbidities, a diagnosis-related group-based mortality risk indicator, @entity10688 code median income, and hospital characteristics, blacks were less likely to receive rt-PA than whites at non-PSCs (odds ratio=0.58, 95% CI 0.50 to 0.67) and PSCs (odds ratio=0.63, 95% CI 0.54 to 0.74) and Hispanics were less likely than whites to receive rt-PA at PSCs (odds ratio=0.77, 95% CI: 0.63 to 0.95). In the fully adjusted model, interaction between race and presentation to a @entity991 for likelihood of receiving rt-PA did not reach significance (P=0.98). CONCLUSIONS: Racial disparities in intravenous rt-PA use were not reduced by presentation to PSCs. Black @entity1 were less likely to receive thrombolytic treatment than white @entity1 at both non-PSCs and PSCs. Hispanic @entity1 were less likely to be seen at PSCs relative to white @entity1 and were less likely to receive intravenous rt-PA in the fully adjusted model.

Racial Disparities in Intravenous Recombinant XXXX Use Persist at Primary @entity64 Centers.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity10688 :: ('1613', 'Gene') :: ['ZIP'] @entity1456 :: ('100128998', 'Gene') :: ['tissue plasminogen activator'] @entity991 :: ('MESH:D015209', 'Disease') :: ['PSC'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity1456 :: (100128998,Gene) :: ['Tissue Plasminogen Activator']
