TUESDAY, April 28 (HealthDay News) -- American heart patients who receive their primary care at a community health clinic are less likely to be referred for a consultation with a cardiologist than patients who receive their primary care at a hospital.

This difference is especially true among women, say researchers who reviewed the electronic medical records of 9,761 adult heart patients who received community clinic-based or hospital-based care between 2000 and 2005.

The overall rates for cardiology consultations were 79.6 percent for patients with coronary artery disease (CAD) and 90.3 percent for congestive heart failure (CHF) patients, said the researchers from Harvard Medical School and the U.S. National Heart, Lung, and Blood Institute (NHLBI).

However, patients seen at community health clinics were less likely (CAD patients 21 percent less, and CHF patients 23 percent less) to receive an initial cardiology consultation than those treated at hospital clinics.

Women with CAD and CHF were 11 percent less likely than men (11 percent and 7 percent, respectively) to be referred for an initial cardiology consultation. Black and Hispanic patients were as likely as whites to receive an initial cardiology consultation.

When they looked at ongoing cardiac consultations, the researchers found that:

• Women had 15 percent fewer follow-up consultations than men.
• Patients treated at community clinics had 20 percent fewer follow-up consultations than those treated at hospital-based practices.
• Blacks and Hispanics had 13 percent fewer follow-up consultations than whites.
• Women, blacks and Hispanics with fewer follow-up consultations had lower cardiac performance measures over five years.

The study was published in the April 27 online issue of Circulation.

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

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