# Physician Networks and the Racial Gap in Hospital Quality of Care for Coronary Heart Disease

> **NIH NIH R01** · RAND CORPORATION · 2020 · $702,374

## Abstract

Project Summary/ Abstract
White-black disparities in the treatment of coronary heart disease (CHD) are due in part to
differences in the quality of hospitals used by black and white patients, and studies suggest that
non-geographic factors play an important role. Such non-geographic factors likely include
differences in the physicians caring for black and white patients with CHD. In support of this
hypothesis, research has shown that the care of black patients is concentrated within a small
number of physicians, who report lower access to specialists and hospitals, and may be more
isolated professionally. In addition, research has shown that black and white patients may be
treated differently even when they are cared for by the same physicians or physician referral
networks. Whether differences among physicians caring for black and white seniors with CHD
contribute to the racial gap in hospital quality remains unknown.
The overarching goal of this proposal is to identify and characterize physicians and networks
treating black and white seniors with CHD, and to investigate the physician and network factors
associated with the racial gap in high quality hospital use using a combination of state of the art
social network and econometric data analyses, and surveys directed at physicians caring for
black and white patients. The study will include seniors in 35 metro areas with sizable black
and white populations and include two cardiac conditions: acute myocardial infarction (AMI), an
emergency condition typically requiring transport to the nearest hospital, and coronary artery
bypass grafting surgery (CABG), a frequently elective procedure involving specialty referral.
Study aims will sequentially construct metro-level networks; identify sub-networks of physicians
within the larger metro area that are likely to work together (i.e., referral networks); measure
network segregation; measure physician and sub-network characteristics that may be relevant
for hospital access and the referral process; survey a sample of physicians within these
networks to understand self-reported difficulties with the referral process; estimate regression
models to assess the effects of physicians and their measured and self-reported characteristics
on the white-black gap in high quality hospital use for CHD; and employ simulations to assess
potential policy effects achieved by modifying relevant characteristics.
The study will address important, previously unanswered questions about physician referral
networks for black and white seniors with CHD in diverse US metro areas. Are networks
segregated, and to what degree is network segregation correlated with residential segregation?
Are characteristics of physicians and sub-networks used by black and white seniors with CHD
(e.g., physician qualifications and the centrality of cardiologists within a sub-network) different
and do they affect the use of high quality hospitals? The study will address these important
research and p...

## Key facts

- **NIH application ID:** 9948725
- **Project number:** 5R01HL148420-02
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Ioana Popescu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $702,374
- **Award type:** 5
- **Project period:** 2019-06-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9948725

## Citation

> US National Institutes of Health, RePORTER application 9948725, Physician Networks and the Racial Gap in Hospital Quality of Care for Coronary Heart Disease (5R01HL148420-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9948725. Licensed CC0.

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