A care pathway approach to identifying factors that impact on diagnosis of heart disease in British Pakistani women

Abstract

Purpose

The authors examined the cardiac care pathway with the aim of identifying factors that impact on diagnosis and treatment of coronary heart disease in British Pakistani women.

Design/methodology/approach

This is an exploratory qualitative study. In depth interviews and focus groups with an opportunistic sample of Pakistani women and a purposive sample of clinicians working at different points along the care pathway were conducted. The authors used a pathways to care approach to illustrate how their individual and cumulative effect may contribute to differential receipt of treatment, including revascularisation, and health inequalities.

Findings

Four major issues were identified: complex life circumstances; “atypical” presentation and symptomatology; problems related to investigative testing; and poor communication. Mapping these barriers onto the Pathways to Care Model provided valuable insight into their impact on patients' progression through the different stages of the care pathway.

Research limitations/implications

Adopting a care pathway approach demonstrated how individual factors have an impact at several points along the care pathway. It indicated where further, more detailed enquiry is merited and where intervention studies might usefully be directed to improve care.

Practical implications

Examining the whole care pathway identified areas of service improvement that merit a co‐ordinated response.

Originality/value

The framework provided by the Pathways to Care Model offered insight into the causes of the previously observed attenuation in women's progress along the cardiac diagnosis and treatment pathway and is an important first step to addressing this health inequality in a holistic way.

Citation

Piercy, H., Chowbey, P., Soady, J., Dhoot, P., Willis, L. and Salway, S. (2012), "A care pathway approach to identifying factors that impact on diagnosis of heart disease in British Pakistani women", Ethnicity and Inequalities in Health and Social Care, Vol. 5 No. 3, pp. 78-88. https://doi.org/10.1108/17570981211319375