American Journal of Epidemiology Vol. 148, No. 8: 741-749
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Ethnic Disparities in Patient Recall of Physician Recommendations of Diagnostic and Treatment Procedures for Coronary Disease
1Division of Cardiovascular Disease, Department of Medicine and Center for Health Promotion, University of Alabama at Birmingham Birmingham, AL
2Schools of Medicine and Public Health and Center for Health Promotion, University of Alabama at Birmingham Birmingham, AL
3School of Health Related Professions and Biostatistics, University of Alabama at Birmingham Birmingham, AL
Despite the proven benefits of many cardiac procedures, some are used less frequently for African American than for white patients with known or suspected coronary disease. This study explored differences between ethnic groups that may affect patient recall of physician recommendations of cardiac procedures. Also examined were patients' responses when asked about adhering to those recommendations. The data examined were collected from interviews with 1,333 African American and white hospital inpatients with known coronary disease admitted to the Birmingham-Black Health Seeking for Coronary Heart Disease Project (1989–1990) in Alabama. Respondents were asked to recall previous health care encounters, physician recommendations of cardiac procedures, and adherence to those recommendations. Compared with whites, fewer African American patients recalled physicians recommending some cardiac procedures. If procedure recommendations were recalled, no ethnic differences were found in patient recall of adhering to those recommendations. Predictors of recall of the recommended procedures were identified by multivariate logistic regression. Patients' knowledge of having coronary disease was the common factor that predicted their recall of all cardiac procedures. Other predictor variables included some cardiac risk factors and symptoms, socioeconomic status, and ethnicity. Although health care practice is influenced by many factors, it is important to examine variables that may lead to a reduction in ethnic disparities in coronary disease morbidity and mortality. Am J Epidemiol 1998; 148: 741–9.
blacks; coronary disease; diagnosis; ethnic groups; physicians
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