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J Card Fail. 2002 Dec;8(6):381-6.

Racial differences in treatment-seeking delays among heart failure patients.

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University of California, Los Angeles, School of Nursing, USA.



Treatment-seeking delays for heart failure (HF) symptoms are significantly high. However, earlier studies did not closely examine race as a characteristic that could potentially influence delay times. The purpose of this study was (1) to describe racial differences in treatment-seeking delays for HF symptoms and (2) to identify racial differences in hospital readmission rates, functional status, and total length of stay.


A retrospective chart review of all patients admitted with HF at a Veterans Administration facility was conducted. The study sample consisted of 753 patients: 456 Caucasians (60.6%), 220 African Americans (29.2%), 41 Asians (5.4%), and 36 Hispanics (4.8%). The average prehospital delay time was 2.9 +/- 0.7 days. Mean delay times were significantly longer for African Americans than for Caucasians, Asians, and Hispanics (P =.019). African Americans also had significantly higher readmission rates (P =.001) and lower functional status (higher New York Heart Association functional class) (P =.034). There were no significant racial differences in total length of stay for HF admissions.


The current study supports that racial differences exist in treatment-seeking behaviors for HF symptoms, hospital readmission rates, and functional status. A better understanding of treatment-seeking behaviors of HF patients with different racial characteristics may be key to early recognition and prevention of complications in this high-risk population; it may be beneficial in identifying patients at risk for treatment delays and potentially poorer outcomes.

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