Physicians’ Perceptions of Patients’ Social and Behavioral Characteristics and Race Disparities in Treatment Recommendations for Men With Coronary Artery Disease

Autor:	Diana J. Burgess, Joan M. Griffin, Michelle van Ryn, Jennifer Malat
Rok vydání:	2006
Předmět:	Male medicine.medical_specialty Research and Practice Attitude of Health Personnel Decision Making MEDLINE Ethnic group Insurance Coverage Coronary artery disease Race (biology) Risk Factors Humans Medicine Coronary Artery Bypass Physician-Patient Relations Stereotyping business.industry Social perception Medical record Public health Public Health Environmental and Occupational Health Race Relations medicine.disease Logistic Models Family medicine Survey data collection Female business Social psychology
Zdroj:	American Journal of Public Health. 96:351-357
ISSN:	1541-0048 0090-0036
DOI:	10.2105/ajph.2004.041806
Popis:	Objectives. A growing body of evidence suggests that provider decisionmaking contributes to racial/ethnic disparities in care. We examined the factors mediating the relationship between patient race/ethnicity and provider recommendations for coronary artery bypass graft surgery. Methods. Analyses were conducted with a data set that included medical record, angiogram, and provider survey data on postangiogram encounters with patients who were categorized as appropriate candidates for coronary artery bypass graft surgery. Results. Race significantly influenced physician recommendations among male, but not female, patients. Physicians’ perceptions of patients’ education and physical activity preferences were significant predictors of their recommendations, independent of clinical factors, appropriateness, payer, and physician characteristics. Furthermore, these variables mediated the effects of patient race on provider recommendations. Conclusions. Our findings point to the importance of research and intervention strategies addressing the ways in which providers’ beliefs about patients mediate disparities in treatment. In addition, they highlight the need for discourse and consensus development on the role of social factors in clinical decisionmaking.
Databáze:	OpenAIRE
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