While the acute myocardial infarction – commonly referred to as a heart attack – remains the leading cause of death in the United States, deaths have declined significantly over the last two decades in part due to improved treatment methods, according to Charleen Hsuan, Associate Professor of Health and Administration. However, not all patients can receive the recommended treatment.
According to a new study, led by HSUAN, Spanish and non-Spanish black patients in Florida, who presented a strong myocardial-emphasis treatment (STEMI)-a serious heart attack, where a large coronary artery is fully blocked Comparison with non-compassionate patients.
The study was recently published in Jama open network.
I have always been interested in the quality of urgent care care and the way this quality can vary between patients based on their insurance status and demographics. There is a lot of research on these differences, making it difficult for policymakers to identify where to pay attention. By focusing on a particular situation, we can begin to understand where they should be focused on combating inequalities in the treatment that patients received. ”
Charleen Hsuan, Associate Professor of Political and Health Administration, Penn State
About a quarter of acute myocardial bumps is STEMIS. Improved methods for the treatment of patients with STEMI include thrombolytic therapy – using drugs to dissolve blood clots – and PCI – a minimally invasive medical procedure that improves blood flow to the heart by expanding narrow or blocked arteries.
According to previous research, PCI reduces mortality in patients with Stemi by about 30%. Clinical guidelines recommend PCI for patients with Stemi within 90 minutes if they reach a PCI hospital and within 120 minutes if hospital transfer is required.
In the present study, to better understand how well the hospitals follow the guidelines and possible care routes available to patients, the research team analyzed a sample of 139,629 patients in the state of Florida diagnosed with Stemi between 2011 and 2021. Hospital.
They found significant racial inequalities at all stages of the emergency care process, according to HSUAN.
Among patients in the sample, 82.6% of non -Spanish white patients first came to a PCI hospital to take care. In contrast, non -Spanish black patients were less likely than white patients to come to a PCI hospital.
Of the black patients who initially reached a PCI hospital, they were 10.7% less likely to receive PCI compared to white patients. Of the patients who initially came to a non -PCI hospital, black patients were 5.3% less likely than white patients to be transferred to another hospital. Of those transported, black patients were 20.3% less likely to receive PCI at the Transport Hospital.
Spanish -speaking patients treated inequalities in some steps in the care process, but not everyone. Spanish -speaking patients were 3.8% less likely than white patients would initially come to a PCI hospital to take care. Spanish -speaking patients who initially came to a non -PCI hospital were 5.6% less likely to be taken to another hospital.
“These are extremely big differences,” Hsuan said. “Everyone was added to explain why previous studies found a higher mortality rate in patients with Stemi who are Spanish and non -Spanish blacks compared to patients who are white.”
According to HSUAN, the study highlights areas where policymakers – both state and federal legislators, along with hospital administrators – could possibly focus their attention, such as if a patient was received by PCI when they were taken to PCI when they were initially PCI.
Because all the data was collected in Florida, the findings of this study cannot necessarily be generalized in the United States. However, Florida is the third most populous state in the nation, making this issue that probably affects millions of Americans, according to HSUAN. More research is needed to determine the guides of these inequalities, which HSUAN’s theory theory could be any number of factors, including insurance disputes, hospital availability or geographical location.
This study is part of a broader HSUAN research series, examining the process and quality of transport care at national level.
“While this study focused on racial and ethnic inequalities, it has a major impact on the quality of everyone’s care,” Hsuan said. “Differences from demographics emphasize that urgent care can be improved for everyone, the basic time is that people do not receive the care of doctors and medical associations, and this study was a big step towards identifying the discourse that we can start with.
Other writers of Penn State in the document include David J. Vanness, Professor of Political and Health Administration. Haoyu Bi, PhD candidate in Policy and Administration Department in Penn State. and Jeannette Rogowski, Professor of Political and Health Management.
Other authors include Michelle P. Lin, Associate Professor of Emergency Medicine at Stanford University. Alexis Zebrowski, Executive Director of Data Strategy at Mount Sinai Health System. Renee Y. Hsia, Professor and Associate of Health Services Research at the University of California San Francisco. Brendan G. Carr, Managing Director of Mount Sinai Health System. Eric Wei, Managing Director of NYC Health + Hospitals/Bellevue and Professor of Medical Emergency at Mount Sinai ICAHN School of Medicine. And David G. Buckler, Director of Medical Emergency Data and Analysis at the Mount Sinai Icahn School of Medicine.
The National Institute for the Health and Health of Minorities, the National Translation Sciences Promotion Center, the National Institute of Health, the Institute of Social Sciences Research and Health College and Human Development in Penn State supported this project.
Source:
Magazine report:
Hsuan, C., et al. (2025). Inequalities by race and nationality in transdermal coronary intervention. Open the Jama Network. Doi.org/10.1001/jamanetworkopen.2025.32660.
