This study employed data from the Medicare administrative files maintained by the Health Care Financing Administration (HCFA) from 1989 through 1996 for the purpose of describing the epidemiology of carotid endarterectomy among all Medicare beneficiaries. The results indicated that the demographic composition of Medicare patients undergoing carotid endarterectomy changed slightly over time. However, throughout the study period, whites remained more likely to undergo the procedure. “Whites constituted 94.0% of patients at the beginning of the observation period and 94.9% at the end (1985 versus 1996 difference, -0.9%; 95% CI, -1.2% to -0.7%).” Furthermore, although case-fatality decreased over time, blacks consistently had higher rates: “white versus black 1985-1996 difference, -0.8%; 95% CI, -1.0% to -0.6%.”

The investigators concluded that “despite the two trend reversals in the annual frequency of carotid endarterectomy, its epidemiology has remained relatively stable since 1985.” However, “the proportion of older, male, and white patients increased imperceptibly but significantly.”