Dr. Oshra  Cohen  Phd image

Dr. Oshra Cohen Phd

200 W 86Th St 1M
New York NY 10024
305 515-5637
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 018103
NPI: 1770720732
Taxonomy Codes:
103TB0200X 103TH0004X

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Can non-medical factors contribute to disparities in coronary heart disease treatments? - Journal of health care for the poor and underserved
Racial/ethnic and sex disparities in coronary heart disease treatment exist. We previously reported that physicians perceive non-clinical variables, such as a patient's desire for a second opinion, as affecting revascularization decisions. The results of that study are further examined here, using factor analysis to identify significant interrelationships among the non-clinical variables, which could contribute to disparities in coronary revascularization (i.e., percutaneous transluminal coronary angioplasty [PTCA] or coronary artery bypass graft [CABG]). Five content themes emerged using factor analysis; these are related to the patient's socioeconomic/lifestyle status, treatment preference, physician interaction, health-assertiveness, and aggressiveness. For the lifestyle theme, family physicians had higher mean scores (14.8) than internists, cardiologists, and cardiothoracic surgeons (13.7, 13.6, and 12.6, respectively; overall p=.001); women had higher mean scores than men (15.0 vs. 13.7; p=.009). This implies that family medicine and female physicians perceived variables pertaining to patients' socioeconomic status or lifestyle (e.g., financial barriers, unlikely to adopt healthy behaviors) as precluding some patients from being revascularized. Additionally, female, more than male, physicians (15.0 vs.13.6; p=.006) perceived health assertive patients (e.g., involved in treatment decisions, will quit smoking) as having easier access to the procedures. The results of the present analysis suggest that disparities in cardiac care arise from complex psychosocial interactions, which are influenced by characteristics of the physician as well as the patient.
Awareness of heart attack symptoms and lifesaving actions among New York City area residents. - Journal of urban health : bulletin of the New York Academy of Medicine
The American Heart Association has a national network of community-based programs designed to reduce response times to cardiac emergencies by improving access to automatic external defibrillators (AEDs) among laypersons. Success of these Operation Heartbeat programs depends in part on the public's knowledge of the warning signs of a myocardial infarction (MI) and appropriate response to cardiac arrest victims. In May 2000, a 7-minute telephone survey was administered to a random sample of adults residing within the American Heart Association affiliate territories of New York, New Jersey, and Connecticut to determine the knowledge of MI symptoms, confidence in cardiopulmonary resuscitation (CPR) use, and the awareness of AEDs. Of the respondents, 60% were women (n=1,128), 83% were Caucasians (n=1,558), 15.2% were non-whites (African American, Asian, or Hispanic), and 38.5% had at least a college degree (n=724). Women were significantly more likely than men to know that sex differences exist in the warning signs for an MI (63% vs. 30.7%, respectively; P< .001). Whites had above-average confidence in MI recognition compared with non-whites (39.2% vs. 27.4%, respectively; P< .001) and were more cognizant of the public availability of AEDs (54.5% vs. 33.2%, respectively; P< .001). Our findings suggest that racial/ethnic and sex disparities exist in the awareness of AEDs and in the knowledge of atypical MI symptoms in women, respectively. Innovative CPR outreach programs might be needed in New York area communities to increase CPR training among all adults, to increase AED awareness in vulnerable populations, and to improve knowledge and confidence in the recognition of acute MI symptoms.

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