Can Non-medical Factors Contribute to Disparities in Coronary Heart Disease Treatments?
Abstract
Racial/ethnic and sex disparities in coronary heart disease treatment exist. We previously reported that physicians perceive non-clinical variables, such as a patient's desire for a second opinion, as affecting revascularization decisions. The results of that study are further examined here, using factor analysis to identify significant interrelationships among the non-clinical variables, which could contribute to disparities in coronary revascularization (i.e., percutaneous transluminal coronary angioplasty [PTCA] or coronary artery bypass graft [CABG]). Five content themes emerged using factor analysis; these are related to the patient's socioeconomic/lifestyle status, treatment preference, physician interaction, health-assertiveness, and aggressiveness. For the lifestyle theme, family physicians had higher mean scores (14.8) than internists, cardiologists, and cardiothoracic surgeons (13.7, 13.6, and 12.6, respectively; overall p=.001); women had higher mean scores than men (15.0 vs. 13.7; p=.009). This implies that family medicine and female physicians perceived variables pertaining to patients' socioeconomic status or lifestyle (e.g., financial barriers, unlikely to adopt healthy behaviors) as precluding some patients from being revascularized. Additionally, female, more than male, physicians (15.0 vs.13.6; p=.006) perceived health assertive patients (e.g., involved in treatment decisions, will quit smoking) as having easier access to the procedures. The results of the p…
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Barnhart et al explored non-medical reasons for disparities in coronary heart disease treatments and discovered that if patients with low SES adopted a health-assertive manner, then their treatment recommendations (revascularisation) more closely mirrored patients who had high SES.
“Barnhart et al 56 explored non-medical reasons for disparities in coronary heart disease treatments and discovered that if patients with low SES adopted a health-assertive manner, then their treatment recommendations (revascularisation) more closely mirrored patients who had high SES.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [56]
Patient assertiveness can lead to more careful diagnostic testing for people who may have been otherwise disadvantaged because of their SES.
“Patient assertiveness can lead to more careful diagnostic testing for people who may have been otherwise disadvantaged because of their SES.56”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [56]
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References 62 · Cited by 17
- Authors
- Barnhart, J. M., Cohen, O., Wright, N., & Wylie-Rosett, J.
- Affiliations
- Albert Einstein College of Medicine (US)
- Yeshiva University (US)
- Venue
- Journal of Health Care for the Poor and Underserved
- Publisher
- Project MUSE
- Published
- 2006-08
- Volume
- 17
- Issue
- 3
- Pages
- 559-574
- ISSN
- 1049-2089 (ISSN-L)
- 1548-6869
- OpenAlex
- W1997113188
- Cited by
- 17
- References
- 62
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 1 · 2017: 1 · 2016: 1 · 2013: 1 · 2012: 1
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Health Care for the Poor and Underserved (publishedVersion)
- PubMed (publishedVersion)
- Project Muse (Johns Hopkins University) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- American Heart Association
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- coronary artery disease, racial and ethnic disparities, sex disparities, coronary revascularization, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, physician perceptions, non-clinical factors, socioeconomic status, lifestyle factors, treatment preferences, second opinion, general practitioners, gender differences in physicians, psychosocial factors
- MeSH terms
- Coronary Artery Bypass, Attitude of Health Personnel, Coronary Disease, Ethnicity, Factor Analysis, Statistical, Female, Humans, Male, Medicine, Middle Aged, Patient Participation, Physician-Patient Relations, Physicians, Sex Factors, Socioeconomic Factors, Specialization, Health Behavior, Angioplasty, Balloon, Coronary, Patient Satisfaction
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