Related Experiment Video
Updated: Jul 30, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Delay in presentation for cardiac care by race, age, and site of care
Joseph Conigliaro1, Jeff Whittle, Chester B Good
1Section of General Internal Medicine, Center for Health Equity Research and Promotion, Geriatric Research Education and Clinical Center, Pittsburgh, Pennsylvania, USA. joseph.conigliaro@med.va.gov
Insights
Racial differences did not influence delays in seeking care for heart disease. However, patients at VA hospitals reported longer delays, and ignoring symptoms was a common reason for delayed treatment.
Area of Science:
- Cardiology
- Health Services Research
- Health Disparities
Background:
- Racial disparities are observed in coronary artery disease (CAD) management.
- A hypothesis suggests that delays in seeking care by Black patients may impact CAD management.
Purpose of the Study:
- To evaluate delays in seeking medical care for heart disease.
- To investigate factors associated with delayed presentation for cardiac care.
Main Methods:
- Cross-sectional survey of 1,652 patients undergoing coronary angiography at VA and non-VA medical centers.
- Retrospective assessment of time from symptom onset to medical presentation and reasons for delay.
Main Results:
- 73% of patients reported delays of 1 month or more; 16% delayed over 6 months.
- Race and age were not associated with delay. VA hospital patients reported longer delays.
- Ignoring symptoms was the most frequent reason for delays exceeding 1 month, particularly in non-VA settings.
Conclusions:
- Patient race was not a significant factor in delaying care for coronary artery disease.
- Care delays were longer at VA facilities, and prior revascularization was associated with shorter delays.
- Further research is needed to understand the patient and provider decision-making processes leading to revascularization.
Background:
Racial differences exist in the management of coronary artery disease. One hypothesis is that black patients delay seeking care and that this delay may influence the management of coronary artery disease.
Objectives:
To assess delay in seeking care for heart disease.
Research Design:
Cross-sectional survey.
Subjects:
One thousand six hundred and fifty-two patients awaiting coronary angiography at three VA and one non-VA Medical Center.
Measures:
Patients were asked to retrospectively report the time between symptom onset and presentation for medical care and what if any were the reasons for delay.
Results:
One thousand five hundred eleven patients (12% VA & 43% non-VA) answered questions regarding delay in treatment. Overall, 73% reported delaying 1 month or more and 16% reported delaying more than 6 months. Black patients and white patients were equally likely to delay as were older persons (> or = 65) compared with younger. Patients at the VA hospitals reported longer delays and patients with prior revascularization were less likely to report delays. We used ordinal logistic regression to predict delay using site type and prior revascularization as covariates. VA site of care independently predicted longer delays whereas prior revascularization predicted less delay. Among patients who reported at least a 1 month delay, patients at the non-VA hospital were more likely to cite ignoring symptoms as their reason for delay (72% vs. 61%; P = 0.03) as were those with at least a high school education 69% versus 50%; P = 0.003). Black patients reported that they ignored their symptom more often but this was marginally significant (77% vs. 63%; P = 0.053).
Conclusions:
Race was not associated with delay in seeking care among patients awaiting coronary angiography. Non-VA patients, and those with past revascularization, were less likely to delay. Ignoring symptoms was the most common reason for delays greater than 1 month. Further study of the sequence of patient and provider decisions that ultimately lead to revascularization is needed.
More Related Videos
07:50Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model
Published on: September 3, 2020
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:28Imaging Studies for Cardiovascular System V: CT
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:26Cardiac Catheterization IV: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies