RACIAL DISPARITY IN CARDIAC DECISION-MAKING - RESULTS FROM PATIENT FOCUS GROUPS

Background: While numerous studies suggest that African Americans rece ive fewer invasive cardiac procedures than whites, the basis for these treatment differences is not understood. Methods: We conducted focus group sessions with patients who had received treatment in the hospita l or the emergency department within the preceding 3 months for ischem ic heart disease at 2 urban, university-affiliate hospitals. Results: Discussions with patients identified the following factors that influe nced their decision making: clarity, simplicity, and consistency of tr eatment recommendations; advice from friends and family about whether to accept recommendations; availability to speak with others who accep ted similar recommendations; and having honest and caring physicians. African American patients identified the following additional factors that influenced their decision making: perceptions of health care disc rimination; perceptions of undesirable physician behavior; faith in Go d to control one's destiny; and patient-physician camaraderie. Conclus ions: Participants identified common issues influencing health care de cision making, regardless of race. However, additional factors were ex pressed only by African American participants. These factors conveyed racial differences in perceptions of the health care system that may, in part, contribute to differences in health care decision making and treatment.