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Erschienen in: Journal of General Internal Medicine 8/2007

01.08.2007 | Populations at Risk

Patient–Provider and Patient–Staff Racial Concordance and Perceptions of Mistreatment in the Health Care Setting

verfasst von: Janice Blanchard, MD, PhD, MPH, Shakti Nayar, BA, Nicole Lurie, MD, MSPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 8/2007

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Abstract

Objectives

To determine what roles patient–provider and patient–staff racial concordance play on patients’ perceptions within the health care setting.

Design, Setting, Participants

Data from the Commonwealth Fund 2001 Quality of Care telephone survey. Analysis focused on the subsample of 6,066 adults who live in the continental United States and who reported having a regular provider or a usual source of care (n = 4,762).

Measurements and Results

We analyzed patients’ responses about perceptions of disrespect, unfair treatment because of race and language, and the belief that he/she would have received better treatment if he/she belonged to a different race. We compared these perceptions of mistreatment with provider and staff racial concordance, controlling for sociodemographic variables. Contrary to our hypothesis, Hispanics were more likely to report being treated with disrespect if in a concordant relationship with their provider than if in a nonconcordant one (odds ratio [OR] 2.42, P < .01). Asians were less likely to report being treated unfairly because of race if in racially concordant relationships with providers than if in nonconcordant ones (P < .05). Hispanics were also less likely to perceive unfair treatment because of language when in concordant relationships with staff as compared to nonconcordant relationships with staff (P < .05).

Conclusions

Patients’ perceptions of health care relationships may partially depend on racial concordance with providers and staff. The nature of the association between racial concordance and perceived disrespect varies by racial group, indicating that other race-specific factors may also need to be examined.
Literatur
1.
Zurück zum Zitat Smedley BD, Stith AY, Nelson AR, eds. Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington DC: National Academy Press; 2002. Smedley BD, Stith AY, Nelson AR, eds. Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington DC: National Academy Press; 2002.
2.
Zurück zum Zitat Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000;57(Suppl 1):108–45.PubMedCrossRef Mayberry RM, Mili F, Ofili E. Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000;57(Suppl 1):108–45.PubMedCrossRef
3.
Zurück zum Zitat East MA, Peterson ED. Understanding racial differences in cardiovascular care and outcomes: issues for the new millennium. Am Heart J. 2000;139:764–6.PubMedCrossRef East MA, Peterson ED. Understanding racial differences in cardiovascular care and outcomes: issues for the new millennium. Am Heart J. 2000;139:764–6.PubMedCrossRef
4.
Zurück zum Zitat Barnett E, Halverson J. Disparities in premature coronary heart disease mortality by region and urbanicity among black and white adults ages 35–64, 1985–1995. Public Health Rep. 2000;115:52–64.PubMed Barnett E, Halverson J. Disparities in premature coronary heart disease mortality by region and urbanicity among black and white adults ages 35–64, 1985–1995. Public Health Rep. 2000;115:52–64.PubMed
5.
Zurück zum Zitat LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and White cardiac patients. Med Care Res Rev. 2000;57(Suppl 1):146–61.PubMedCrossRef LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and White cardiac patients. Med Care Res Rev. 2000;57(Suppl 1):146–61.PubMedCrossRef
6.
Zurück zum Zitat Blanchard J, Lurie N. R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. J Fam Pract. 2004;53(9):721–30.PubMed Blanchard J, Lurie N. R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. J Fam Pract. 2004;53(9):721–30.PubMed
7.
Zurück zum Zitat LaVeist TA, Nuru-Jeter A, Jones KE. The association of doctor–patient race concordance with health services utilization. J Public Health Policy. 2003;24(3–4):312–23.PubMedCrossRef LaVeist TA, Nuru-Jeter A, Jones KE. The association of doctor–patient race concordance with health services utilization. J Public Health Policy. 2003;24(3–4):312–23.PubMedCrossRef
8.
Zurück zum Zitat Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender, and partnership in the patient–physician relationship. JAMA. 1999;282(6):583–9.PubMedCrossRef Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender, and partnership in the patient–physician relationship. JAMA. 1999;282(6):583–9.PubMedCrossRef
9.
Zurück zum Zitat Kaplan SH, Greenfield S, Gandex B, Rogers WH, Ware JE. Characteristics of physicians with participatory decision-making styles. Ann Intern Med. 1996;124:497–504.PubMed Kaplan SH, Greenfield S, Gandex B, Rogers WH, Ware JE. Characteristics of physicians with participatory decision-making styles. Ann Intern Med. 1996;124:497–504.PubMed
10.
Zurück zum Zitat Putnam SM, Stiles WB, Jacob MC, James SA. Patient exposition and physician explanation in initial medical interviews and outcomes of clinical visits. Med Care. 1985;23:74–83.PubMedCrossRef Putnam SM, Stiles WB, Jacob MC, James SA. Patient exposition and physician explanation in initial medical interviews and outcomes of clinical visits. Med Care. 1985;23:74–83.PubMedCrossRef
11.
Zurück zum Zitat Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.PubMed Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.PubMed
12.
Zurück zum Zitat Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff. 2000;19(4):76–83.CrossRef Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff. 2000;19(4):76–83.CrossRef
13.
Zurück zum Zitat Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient–physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997–1004.PubMedCrossRef Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient–physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159(9):997–1004.PubMedCrossRef
14.
Zurück zum Zitat LaVeist TA, Carroll T. Race of physician and satisfaction with care among African-American patients. J Natl Med Assoc. 2002;94(11):937–43.PubMed LaVeist TA, Carroll T. Race of physician and satisfaction with care among African-American patients. J Natl Med Assoc. 2002;94(11):937–43.PubMed
15.
Zurück zum Zitat LaVeist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;43(3):296–306.PubMedCrossRef LaVeist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;43(3):296–306.PubMedCrossRef
16.
Zurück zum Zitat Garcia JA, Paterniti DA, Romano PS, Kravitz RL. Patient preferences for physician characteristics in university-based primary care clinics. Ethn Dis. 2003;13(2):259–67.PubMed Garcia JA, Paterniti DA, Romano PS, Kravitz RL. Patient preferences for physician characteristics in university-based primary care clinics. Ethn Dis. 2003;13(2):259–67.PubMed
17.
Zurück zum Zitat O’Malley KJ, Haidet P, Sharf B, et al. Trust in physician, facility, and system: qualitative differences between ethnic groups. SGIM 2003 Annual Meeting. O’Malley KJ, Haidet P, Sharf B, et al. Trust in physician, facility, and system: qualitative differences between ethnic groups. SGIM 2003 Annual Meeting.
18.
Zurück zum Zitat Princeton Survey Research Associates for Commonwealth Fund, 2002. Methodology: Survey on disparities in quality of health care. Spring 2001. Princeton Survey Research Associates for Commonwealth Fund, 2002. Methodology: Survey on disparities in quality of health care. Spring 2001.
19.
Zurück zum Zitat STATA Version 6.0. College Station, Tex: STATA Corporation; 1999. STATA Version 6.0. College Station, Tex: STATA Corporation; 1999.
20.
Zurück zum Zitat Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL. Primary care physicians who treat blacks and whites. New Engl J Med. 2004;351(6);575–84.PubMedCrossRef Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL. Primary care physicians who treat blacks and whites. New Engl J Med. 2004;351(6);575–84.PubMedCrossRef
21.
Zurück zum Zitat Malat J, Van Ryn M. African-American preference for same-race healthcare providers: the role of healthcare discrimination. Ethn Dis. 2005;15(4):740–47.PubMed Malat J, Van Ryn M. African-American preference for same-race healthcare providers: the role of healthcare discrimination. Ethn Dis. 2005;15(4):740–47.PubMed
22.
Zurück zum Zitat Gray B, Stoddard J. Patient-physician pairing: does racial and ethnic congruity influence selection of a regular physician. J Commun Health. 1997;22(4):247–59.CrossRef Gray B, Stoddard J. Patient-physician pairing: does racial and ethnic congruity influence selection of a regular physician. J Commun Health. 1997;22(4):247–59.CrossRef
23.
Zurück zum Zitat Cohen JJ. The consequences of premature abandonment of affirmative action in medical school admissions. JAMA. 2003;289:1143–9.PubMedCrossRef Cohen JJ. The consequences of premature abandonment of affirmative action in medical school admissions. JAMA. 2003;289:1143–9.PubMedCrossRef
24.
Zurück zum Zitat Lieu TA, Finkelstein JA, Lozano P, et al. Cultural competence policies and other predictors of asthma care quality for Medicaid-insured children. Pediatrics. 2004;114(1):e102–10.PubMedCrossRef Lieu TA, Finkelstein JA, Lozano P, et al. Cultural competence policies and other predictors of asthma care quality for Medicaid-insured children. Pediatrics. 2004;114(1):e102–10.PubMedCrossRef
25.
Zurück zum Zitat Flores G, Gee D, Kastner B. The teaching of cultural issues in U. S. and Canadian medical schools. Acad Med. 2000;75:451–5.PubMedCrossRef Flores G, Gee D, Kastner B. The teaching of cultural issues in U. S. and Canadian medical schools. Acad Med. 2000;75:451–5.PubMedCrossRef
26.
Zurück zum Zitat Pena DE, Munoz C, Grumbach K. Cross-cultural education in U.S. medical schools: development of an assessment tool. Acad Med. 2003;78:615–22.CrossRef Pena DE, Munoz C, Grumbach K. Cross-cultural education in U.S. medical schools: development of an assessment tool. Acad Med. 2003;78:615–22.CrossRef
27.
Zurück zum Zitat Ferguson WJ, Keller DM, Haley HL, Quirk M. Developing culturally competent community faculty: a model program. JAMA. 2003;78:1221–8. Ferguson WJ, Keller DM, Haley HL, Quirk M. Developing culturally competent community faculty: a model program. JAMA. 2003;78:1221–8.
28.
Zurück zum Zitat Hampers LC, McNulty JE. Professional interpreters and bilingual physicians in a pediatric emergency department: effect on resource utilization. Arch Pediatr Adolesc Med. 2002;156:1108–13.PubMed Hampers LC, McNulty JE. Professional interpreters and bilingual physicians in a pediatric emergency department: effect on resource utilization. Arch Pediatr Adolesc Med. 2002;156:1108–13.PubMed
Metadaten
Titel
Patient–Provider and Patient–Staff Racial Concordance and Perceptions of Mistreatment in the Health Care Setting
verfasst von
Janice Blanchard, MD, PhD, MPH
Shakti Nayar, BA
Nicole Lurie, MD, MSPH
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 8/2007
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0210-8

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