Racial and Ethnic Disparities in Care

The Perspectives of Cardiologists

Published in: Circulation, v. 111, no. 10, Mar. 2005, p. 1264-1269

Posted on RAND.org on January 01, 2005

by Nicole Lurie, Allen Fremont, Arvind Jain, Stephanie L. Taylor, Rebecca McLaughlin, Eric D. Peterson, B. Waine Kong, T. Bruce Ferguson, Jr.

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BACKGROUND: Despite extensive documentation of racial and ethnic disparities in care, provider awareness of disparities has been thought to be low. To be effective, educational efforts for physicians must consider providers' knowledge and beliefs about what causes disparities and what can be done about them. METHODS AND RESULTS: The authors conducted a Web-based survey of 344 cardiologists to determine their level of awareness of disparities and views of underlying causes. Responses were assessed by means of 5-point Likert scales. Thirty-four percent of cardiologists agreed that disparities existed in care overall in the US healthcare system, and 33% agreed that disparities existed in cardiovascular care. Only 12% felt disparities existed in their own hospital setting, and even fewer, 5%, thought disparities existed in the care of their own patients. Despite this, most respondents rated the strength of the evidence about disparities as very strong or strong. Respondents identified many potential causes for disparities in care but were more likely to endorse patient and system level factors (eg, insurance status or adherence) rather than provider level factors. CONCLUSIONS: Cardiologists' awareness of disparities in care remains low, and awareness is inversely proportional to proximity to their own practice setting.

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