Do patient preferences contribute to racial differences in cardiovascular procedure use? J Gen Intern Med 1997 May;12(5):267-73
Date
05/01/1997Pubmed ID
9159695Pubmed Central ID
PMC1497106DOI
10.1046/j.1525-1497.1997.012005267.xScopus ID
2-s2.0-0030972866 (requires institutional sign-in at Scopus site) 130 CitationsAbstract
OBJECTIVE: To determine whether patient preferences for the use of coronary revascularization procedures differ between white and black Americans.
DESIGN: Cross-sectional survey.
SETTING: Tertiary care Department of Veterans Affairs hospital.
PATIENTS: Outpatients with and without known coronary artery disease were interviewed while awaiting appointments (n = 272). Inpatients awaiting catheterization were approached the day before the scheduled procedure (n = 80). Overall, 118 blacks and 234 whites were included in the study.
MEASUREMENTS AND MAIN RESULTS: Patient responses to questions regarding (1) willingness to undergo angioplasty or coronary artery bypass surgery if recommended by their physician and (2) whether they would elect bypass surgery if they were in either of two hypothetical scenarios, one in which bypass surgery would improve symptoms but not survival and one in which it would improve both symptoms and survival. Blacks were less likely to say they would undergo revascularization procedures than whites. However, questions dealing with familiarity with the procedure were much stronger predictors of a positive attitude toward the procedure use. Patients who were not working or over 65 years of age were also less interested in procedure use. In multivariable analysis race was not a significant predictor of attitudes toward revascularization except for angioplasty recommended by their physician.
CONCLUSIONS: Racial differences in revascularization rates may be due in part to differences in patient preferences. However, preferences were more closely related to questions assessing various aspects of familiarity with the procedure. Patients of all races may benefit from improved communication regarding proposed revascularization. Further research should address this issue in patients contemplating actual revascularization.
Author List
Whittle J, Conigliaro J, Good CB, Joswiak MAuthor
Jeffrey Whittle MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Analysis of Variance
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Coronary Disease
Cross-Sectional Studies
Data Collection
Decision Making
Health Knowledge, Attitudes, Practice
Hospitals, Veterans
Humans
Male
Middle Aged
Multivariate Analysis
Patient Satisfaction
Pennsylvania
Physician-Patient Relations
