Delays in Seeking Care

Walsh, Mary Norine; Joynt, Karen E.

doi:10.1161/circoutcomes.116.002668

Cited by 12 publications

(5 citation statements)

References 27 publications

(27 reference statements)

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“…This is in line with previous studies reporting prolonged time delays especially in women [31, 32]. Many studies refer to differences in women’s atypical symptoms of ACS or women’s interpretation of those symptoms [31, 33, 34]. We also found health care-related time delays in women reflected by longer FMC-to-PCI times in women as well as longer CPU admission-to-PCI times.…”

Section: Discussionsupporting

confidence: 92%

Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Settelmeier

Rassaf

Hochadel³

et al. 2020

Cardiology

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Introduction: Gender-specific atypical clinical presentation in acute coronary syndrome and sex-specific outcomes in cardiovascular disease in women are well known. The aim of this study is to analyze possible differences between men and women presenting to certified German chest pain units (CPUs). Methods: Data from 13,900 patients derived from the German CPU registry were analyzed for gender differences in patient characteristics, cardiovascular disease manifestation, critical time intervals, treatment and prognosis. Results: A total of 37.8% of patients were female. Typical chest pain occurred more frequently in men, while atypical symptoms occurred more frequently in women. Female gender was associated with longer pre-and in-hospital time delays. Women were more often diagnosed with a nonischemic origin of pain. In a 3-month follow-up, there was no gender-specific difference in combined major adverse coronary and cerebrovascular events. Discussion/Conclusion: This study points out gender-specific differences in prehospital time intervals and a significantly higher percentage of atypical symptoms in suspected myocardial ischemia as well as more noncoronary diagnoses in women. Symptom awareness and a broader diagnostic workup in women are essential.

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Section: Discussionsupporting

confidence: 92%

Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Settelmeier

Rassaf

Hochadel³

et al. 2020

Cardiology

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“…Women may not prioritize their health, resulting in delays in seeking treatment [ 34 ]. However, our findings differ from those of Walsh and Joynt [ 35 ], who found that women with stroke were 0.66 times as likely to experience treatment delays as males ( p =0.04). The difference is likely due to the fact that stroke symptoms can be more severe and sudden, making them harder to ignore than CHD, which is often without symptoms.…”

Section: Discussioncontrasting

confidence: 99%

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia

Tuminah,

Indrawati,

Riyadina

et al. 2024

PHRP

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Objectives: The aim of this study was to investigate the relationship between the number of patient comorbidities and the delays in seeking treatment for coronary heart disease (CHD).Methods: This longitudinal study utilized secondary data from the Non-Communicable Disease Risk Factor (NCDRF) cohort study conducted in Bogor City. Individuals who participated in the NCDRF cohort study and were diagnosed with CHD within the 6-year study period met the inclusion criteria. Respondents who were not continuously monitored up to the 6th year were excluded. The final sample included data from respondents with CHD who participated in the NCDRF cohort study and were monitored for the full 6-year duration. The final logistic regression analysis was conducted on data collected from 812 participants.Results: Among the participants with CHD, 702 out of 812 exhibited a delay in seeking treatment. The risk of a delay in seeking treatment was significantly higher among individuals without comorbidities, with an odds ratio (OR) of 3.5 (95% confidence interval [CI], 1.735–7.036; p<0.001). Among those with a single comorbidity, the risk of delay in seeking treatment was still notable (OR, 2.6; 95% CI, 1.259–5.418; p=0.010) when compared to those with 2 or more comorbidities. These odds were adjusted for age, sex, education level, and health insurance status.Conclusion: The proportion of patients with CHD who delayed seeking treatment was high, particularly among individuals with no comorbidities. Low levels of comorbidity also appeared to correlate with a greater tendency to delay in seeking treatment.

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“…36 Neighborhood disadvantage may restrict access to health care such as lack of nearby hospitals or regular primary care provider, 37 thereby increasing the risk of delayed and/or missed care, a poor prognostic factor for CVD. 38 Current evidence suggests that Black race is a strong, independent predictor of long delay times (symptom onset to hospital presentation) for patients with myocardial infarction (MI). 39 Low SES, low education, and Black race have all been implicated as risk factors for delayed care.…”

Section: Neighborhood and Physical Environmentmentioning

confidence: 99%

Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease

Javed

Maqsood

Yahya

et al. 2022

Circ: Cardiovascular Quality and Outcomes

187

117

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Health care in the United States has seen many great innovations and successes in the past decades. However, to this day, the color of a person’s skin determines—to a considerable degree—his/her prospects of wellness; risk of disease, and death; and the quality of care received. Disparities in cardiovascular disease (CVD)—the leading cause of morbidity and mortality globally—are one of the starkest reminders of social injustices, and racial inequities, which continue to plague our society. People of color—including Black, Hispanic, American Indian, Asian, and others—experience varying degrees of social disadvantage that puts these groups at increased risk of CVD and poor disease outcomes, including mortality. Racial/ethnic disparities in CVD, while documented extensively, have not been examined from a broad, upstream, social determinants of health lens. In this review, we apply a comprehensive social determinants of health framework to better understand how structural racism increases individual and cumulative social determinants of health burden for historically underserved racial and ethnic groups, and increases their risk of CVD. We analyze the link between race, racism, and CVD, including major pathways and structural barriers to cardiovascular health, using 5 distinct social determinants of health domains: economic stability ; neighborhood and physical environment ; education ; community and social context ; and healthcare system . We conclude with a set of research and policy recommendations to inform future work in the field, and move a step closer to health equity.

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Delays in Seeking Care

Cited by 12 publications

References 27 publications

Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Gender Differences in Patients Admitted to a Certified German Chest Pain Unit: Results from the German Chest Pain Unit Registry

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia

Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease

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