Access to care as a predictor of patients' knowledge of cardiovascular diseases

To determine if a patient's degree of access to healthcare predicts his or her fund of knowledge about cardiovascular diseases.

Trained research associates at a public, urban emergency department in New York City administered cross-sectional surveys to selected patients from June 2005 to January 2007. "Best" access to healthcare was defined by: 1) a regular relationship with one physician and 2) receiving care at a private office or health maintenance organization (HMO). Fund of knowledge was evaluated using previously validated questions.

Participants in this study (n=655) represented diverse racial, economic and educational backgrounds. In unadjusted analyses, participants with the best access to care fared significantly better in three tests evaluating fund of knowledge about hypertension (p=0.049), heart attack symptoms (p=0.004) and heart disease mortality (p=0.002). After adjustment for confounding variables such as race, income and educational background, access to care was no longer significantly correlated with respondents' fund of knowledge about hypertension, heart attack or heart disease.

Patients with different levels of access to care--after controlling for race, education and income--appear to have similar funds of knowledge about cardiovascular diseases. Disparities in knowledge persist across racial and socioeconomic boundaries.