Document Detail


Race differences in cardiac catheterization: the role of social contextual variables.
MedLine Citation:
PMID:  20383600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Race differences in the receipt of invasive cardiac procedures are well-documented but the etiology remains poorly understood.
OBJECTIVE: We examined how social contextual variables were related to race differences in the likelihood of receiving cardiac catheterization in a sample of veterans who were recommended to undergo the procedure by a physician.
DESIGN: Prospective observational cohort study.
PARTICIPANTS: A subsample from a study examining race disparities in cardiac catheterization of 48 Black/African American and 189 White veterans who were recommended by a physician to undergo cardiac catheterization.
MEASURES: We assessed social contextual variables (e.g., knowing somebody who had the procedure, being encouraged by family or friends), clinical variables (e.g., hypertension, maximal medical therapy), and if participants received cardiac catheterization at any point during the study.
KEY RESULTS: Blacks/African Americans were less likely to undergo cardiac catheterization compared to Whites even after controlling for age, education, and clinical variables (OR = 0.31; 95% CI, 0.13, 0.75). After controlling for demographic and clinical variables, three social contextual variables were significantly related to increased likelihood of receiving catheterization: knowing someone who had undergone the procedure (OR = 3.14; 95% CI, 1.70, 8.74), social support (OR = 2.05; 95% CI, 1.17, 2.78), and being encouraged by family to have procedure (OR = 1.45; 95% CI, 1.08, 1.90). After adding the social contextual variables, race was no longer significantly related to the likelihood of receiving catheterization, thus suggesting that social context plays an important role in the relationship between race and cardiac catheterization.
CONCLUSIONS: Our results suggest that social contextual factors are related to the likelihood of receiving recommended care. In addition, accounting for these relationships attenuated the observed race disparities between Whites and Blacks/African Americans who were recommended to undergo cardiac catheterization by their physicians.
Authors:
Brian J Ayotte; Nancy R Kressin
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-04-10
Journal Detail:
Title:  Journal of general internal medicine     Volume:  25     ISSN:  1525-1497     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2011-04-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  814-8     Citation Subset:  IM    
Affiliation:
Center for Organizational, Leadership, and Management Research, VA Boston Healthcare System, Boston, MA, USA. brian.ayotte@va.gov
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MeSH Terms
Descriptor/Qualifier:
African Americans / statistics & numerical data*
Cardiac Catheterization / statistics & numerical data*
Confidence Intervals
Demography
European Continental Ancestry Group / statistics & numerical data*
Female
Health Knowledge, Attitudes, Practice
Healthcare Disparities*
Humans
Interpersonal Relations*
Logistic Models
Male
Massachusetts
Middle Aged
Odds Ratio
Patient Satisfaction / statistics & numerical data
Prospective Studies
Questionnaires
ROC Curve
Social Environment*
Social Support
Socioeconomic Factors
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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