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