Patient race is a determinant in receiving coronary angiograph...( althcare quality. The study was ...),Health

The study was conducted using data from the Cardiac Access Longitudinal Study, which is an ongoing study of medical care access, utilization, and quality of life among white and African American cardiac patients from three hospitals in Baltimore, Md. Two of the hospitals have a cardiac catheterization lab and the third refers patients to facilities to have the coronary angiography procedure done. Records for 7,929 patients were examined and, using the American College of Cardiology/American Heart Association criteria, classified into one of three classes for need of coronary angiography. Class 1 patients were those who received the procedure. Class 2 patients received the procedure frequently, but not consistently. Coronary angiography was not necessary for patients placed in class 3. Researchers supplemented the data found in the records with phone calls to patients.

Because it is not known why fewer African Americans are referred for the procedure, researchers question if these patients are signaling to physicians, in direct or indirect ways, that they would not be willing to submit to an invasive procedure such as coronary angiography or if physicians may simply assume this fact without communication from the patient. Previous research showed that patients are unwilling to undergo procedures if they lack a familiarity with a particular treatment. Researchers also question whether some physicians hold a preconceived belief that African-American patients will not comply with suggestions for treatment, and thus, will not refer that patient.

"Once a referral is obtained, African-American patients are not less likely than white patients to follow through with the procedure. Thus, future research should seek to better understand the process by which the decision is made to refer or not refer patients," said Dr. LaVeist.

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Contact: Kenna Brigham
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
19-Sep-2002