ETHNIC DISPARITIES IN PATIENT RECALL OF PHYSICIAN RECOMMENDATIONS OF DIAGNOSTIC AND TREATMENT PROCEDURES FOR CORONARY-DISEASE

Despite the proven benefits of many cardiac procedures, some are used less frequently for African American than for white patients with know n or suspected coronary disease. This study explored differences betwe en ethnic groups that may affect patient recall of physician recommend ations of cardiac procedures, Also examined were patients' responses w hen asked about adhering to those recommendations. The data examined w ere collected from interviews with 1,333 African American and white ho spital inpatients with known coronary disease admitted to the Birmingh am-Black Health Seeking for Coronary Heart Disease Project (1989-1990) in Alabama. Respondents were asked to recall previous health care enc ounters, physician recommendations of cardiac procedures, and adherenc e to those recommendations. Compared with whites, fewer African Americ an patients recalled physicians recommending some cardiac procedures. If procedure recommendations were recalled, no ethnic differences were found in patient recall of adhering to those recommendations. Predict ors of recall of the recommended procedures were identified by multiva riate logistic regression. Patients' knowledge of having coronary dise ase was the common factor that predicted their recall of all cardiac p rocedures. Other predictor variables included some cardiac risk factor s and symptoms, socioeconomic status, and ethnicity. Although health c are practice is influenced by many factors, it is important to examine variables that may lead to a reduction in ethnic disparities in coron ary disease morbidity and mortality.