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"Access to a cardiology specialist is often a prerequisite for obtaining cardiovascular procedures," said Nakela Cook, M.D., M.P.H., lead author of the study and a clinical medical officer at NHLBI. "In this group, consultation with cardiology specialists improved the quality of medical care and reduced disparities in treatment of women."

Researchers considered the number of follow-up consultations as a proxy for co-managing cardiovascular patients meaning that both their primary care physician and cardiologist were treating their condition and monitoring their progress.

"This was underscored by the fact that women who had consistent follow-up consultations achieved cardiac performance goals equal to those of men despite having lower scores at the outset," Cook said. "Consultation seemed to narrow the gender gap."

The site where patients receive their primary care is particularly relevant in understanding the disparities, because community-based health centers serve a large proportion of racial and ethnic minorities who are either uninsured or have Medicaid.

"We need to raise awareness that differential referral patterns exist and that these differing patterns may affect the quality of care received," Cook said. "Overall, the quality of care in these ambulatory settings was sub-optimal. What we have learned from studies of quality of care in the hospital or at hospital discharge is that placing focus on quality improves achievement of performance measures."

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