Conigliaro J, Whittle J, Good CB, Skanderson M, Kelley M, Goldberg K.
Delay in presentation for cardiac care by race, age, and site of care.
Med Care 2002;40(1 Suppl):I97-105.

The purpose of this study was to assess the effect of race and other variables on the delay in seeking care for health disease symptoms in a large population of veterans.

The initial sample selection identified all white and black consecutive patients who were scheduled for coronary angiography at three Veterans Affairs (VA) medical centers and one civilian hospital. (Dates for the study were not provided.) Using the cardiac catheterization schedule at each institution, all black patients scheduled for angiography during the study period and a random sample of white patients scheduled for angiography within one day were identified from the initially selected sample. Each person was contacted for interview; interviewers were of both races and genders.

Most of the patients (89%) reported delay in seeking care. Black and white patients were equally likely to delay seeking treatment at the time their symptoms were first noticed. Patients undergoing angiography at a VA hospital had longer delays, patients with prior history of revascularization had shorter delays, and educational status was not associated with delay. Both black and white patients delayed care because they ignored their symptoms. There were no significant racial differences in the reasons for the delay.

The authors conclude “these findings (of no significant race pattern in delays in seeking treatment among patients with similar clinical presentations) are important because delay in care-seeking behavior has been hypothesized as one contributor to lower rates of coronary revascularization among black patients compared with white patients.”

The limitations of this study include the lack of information regarding severity, and a slightly different recall period for blacks and whites.