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01.05.2008 | Clinical Review

Racial and Ethnic Disparities in the VA Health Care System: A Systematic Review

verfasst von: Somnath Saha, MD, MPH, Michele Freeman, MPH, Joahd Toure, MD, Kimberly M. Tippens, ND, Christine Weeks, Said Ibrahim, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 5/2008

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Abstract

Objectives

To better understand the causes of racial disparities in health care, we reviewed and synthesized existing evidence related to disparities in the “equal access” Veterans Affairs (VA) health care system.

Methods

We systematically reviewed and synthesized evidence from studies comparing health care utilization and quality by race within the VA.

Results

Racial disparities in the VA exist across a wide range of clinical areas and service types. Disparities appear most prevalent for medication adherence and surgery and other invasive procedures, processes that are likely to be affected by the quantity and quality of patient–provider communication, shared decision making, and patient participation. Studies indicate a variety of likely root causes of disparities including: racial differences in patients’ medical knowledge and information sources, trust and skepticism, levels of participation in health care interactions and decisions, and social support and resources; clinician judgment/bias; the racial/cultural milieu of health care settings; and differences in the quality of care at facilities attended by different racial groups.

Conclusions

Existing evidence from the VA indicates several promising targets for interventions to reduce racial disparities in the quality of health care.

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Titel: Racial and Ethnic Disparities in the VA Health Care System: A Systematic Review
verfasst von: Somnath Saha, MD, MPH
Michele Freeman, MPH
Joahd Toure, MD
Kimberly M. Tippens, ND
Christine Weeks
Said Ibrahim, MD, MPH
Publikationsdatum: 01.05.2008
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 5/2008
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-008-0521-4

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