This study evaluates the role of neurologists in explaining African American-White differences in the use of diagnostic and therapeutic services for cerebrovascular disease. Principal Findings Even after adjusting for patient demographics, comorbidity, ability to pay, and provider characteristics, African American patients were significantly less likely to receive noninvasive cerebrovascular testing, cerebral angiography, or carotid endarterectomy, compared with white patients, and to have a neurologist as their attending physician. At the same time, patients treated by neurologists were more likely to undergo diagnostic testing and less likely to undergo carotid endarterectomy. All Medicare claims were extracted for a 30-day period beginning with the date of admission. The findings suggest that African American patients with TIA may have less access to services for cerebrovascular disease and that at least some of this may be attributed to less access to neurologists.
More research is needed on how patients at risk for stroke are referred to specialists.
Official journal of the Academy for Health Services Research and Health Policy. Association for Health Services Research . All rights reserved.