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Trends in implantable cardioverter-defibrillator racial disparity

The importance of geography

Peter W. Groeneveld, MD, MS^*,,,*, Paul A. Heidenreich, MD, MS^,|| and Alan M. Garber, MD, PhD^,||,¶

^* Center for Health Equity Research and Promotion, Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Division of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
Veterans Affairs Palo Alto Health Care System, Palo Alto, California
^|| Center for Primary Care and Outcomes Research, Stanford University, Stanford, California
^¶ National Bureau of Economic Research, Stanford, California

View larger version (43K): [in a new window]   Figure 1 Implantable cardioverter-defibrillators (ICDs) implanted among elderly ventricular arrhythmia patients, by year. The y-axis represents the percentage of the target population receiving ICDs for each year indicated on the x-axis. Black bars = ICD implants among white patients admitted to non-academic hospitals; diagonally cross-hatched bars = ICD implants among black patients admitted to non-academic hospitals; white bars = implants among white patients admitted to academic hospitals; horizontally cross-hatched bars = ICD implants among black patients admitted to academic hospitals.

View larger version (16K): [in a new window]   Figure 2 Time trends in geographic disparity. The y-axis represents the percentage of the target population receiving implantable cardioverter-defibrillators (ICDs) for each time period listed on the x-axis. Solid line = ICDs implanted in academic medical centers in counties with <10% black population; dashed line = ICDs implanted in academic medical centers in counties with >10% black population; dot-dashed line = ICDs implanted in non-academic medical centers in counties with <10% black population; dotted line = ICDs implanted in non-academic medical centers in counties with >10% black population.