Minority men and women are less likely than whites overall to receive diagnostic and therapeutic procedures for the treatment of heart disease. Moreover, a recent study found that minority patients who do undergo these life-saving procedures often do so in the hands of surgeons or in hospitals with higher risk-adjusted mortality rates. This project seeks to understand the dynamics that prevent minority patients from accessing high-quality cardiac surgeons. Specifically, it will analyze data for Medicare beneficiaries in New York State who underwent coronary artery bypass graft surgery to identify factors associated with referral to poorer-outcome surgeons and facilities. It will also examine whether a correlation exists between needing emergent surgery and receiving poorer-outcome surgical care, and whether minority patients receive poorer-outcome surgical care because they are hospitalized in facilities with a concentration of surgeons with higher risk-adjusted mortality rates. Project staff will identify numerous areas for future interventions to improve cardiac care for minority patients. http://www.uci.edu/