Patient preferences: do they contribute to healthcare disparities?

OBJECTIVES The purpose of this study was to examine the effect of race on whether or not a patient would accept an invasive cardiac procedure when referred by a physician. METHODS A retrospective longitudinal review of medical records at a public health hospital in southeastern Louisiana was conducted to determine cardiovascular patient acceptance/ rejection differences. Patient charts were examined using specific indicators (type of pain, laboratory values, blood pressure, and radiographic tests) to determine which patients were eligible to be referred. In order to be selected, each medical record had to have documentation of a physician referral for an invasive cardiac procedure. Medical charts without this referral were deemed ineligible for the cohort. RESULTS Patient preferences were similar for both minorities and Caucasians, despite the fact that the study controlled for disease severity, age, income, sex, race, social support, diagnosis, and family history. CONCLUSION Race did not contribute to disparate acceptance and rejection rates among African Americans and Caucasians. A possible reason for this occurrence is that the site was a teaching hospital, which may indicate more physician oversight and better articulation of treatment options. Future studies should delve deeper into physician and institutional bias in non-teaching facilities during patient/physician interactions.