Patients at community health clinics less likely to be referred to ca...( Heart patients who receive primary c...),Health

Heart patients who receive primary care at community health clinics especially women are less likely to have a consultation with a cardiologist than those who receive primary care at hospitals, according to a study in Circulation: Journal of the American Heart Association.

Researchers from the National Heart, Lung, and Blood Institute (NHLBI) and Harvard Medical School reviewed the electronic medical records of 9,761 adult patients who received primary care at either hospital-based clinics or community-based primary care centers affiliated with two large academic medical centers between 2000󈝱. They analyzed the likelihood of obtaining initial and ongoing cardiac consultations by site of primary care and socio-demographic characteristics.

Overall rates for cardiology consultations were higher than previously reported 79.6 percent of coronary artery disease (CAD) patients and 90.3 percent of congestive heart failure (CHF) patients. However, patients seen at the community-based health centers received fewer cardiology consultations than those seen at hospital-based settings, while women seen in all settings were less likely than men to be referred to a cardiologist.

The analysis for initial consultations over the five-year study period showed:

• CAD patients seen at the community-based health centers were 21 percent less likely to receive an initial cardiology consultation than patients treated at hospital clinics, while CHF patients were 23 percent less likely.
• Women with CAD were 11 percent less likely than men to be referred for an initial cardiology consultation, and women with CHF were 7 percent less likely.
• African-American and Hispanic patients were just as likely or more likely than their white counterparts to receive an initial cardiology consultation.

For ongoing cardiac consultations, researchers found that:

• Women had 15 percent fewer follow-up consultatio
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