Racial Disparities in Access to Renal Transplantation — Clinically Appropriate or Due to Underuse or Overuse?

Numerous studies performed over the past decade have documented racial disparities in the use of effective surgical procedures, 1 – 9 both discretionary and nondiscretionary, 10 and there is no evidence that these differences have diminished substantially. The failure to improve black patients' relative access to surgical procedures may reflect skepticism on the part of clinicians and policymakers about the interpretation of inequities. Indeed, rates of use alone are not valid indicators of the quality of care. The critical questions are whether blacks are less likely than whites to undergo necessary surgical procedures, and whether whites are more likely than blacks to undergo . . .