Race and trust in the health care system.
Race and trust in the health care system.
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对医疗保健系统的种族和信任。
DOI：
10.1093/phr/118.4.358
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Powe,NeilR
中科院分区：
文献类型：
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作者：
Boulware,LEbony;Cooper,LisaA;Ratner,LloydE;LaVeist,ThomasA;Powe,NeilR
医学研究和医疗保健系统中的种族歧视遗产与非裔美国人对医学研究和医疗保健的信任程度低有关。虽然对医生的信任存在种族差异，但人们对健康保险计划和医院的信任存在种族差异却知之甚少。在本研究中，作者分析了一个横断面电话调查的反应，以评估独立的关系，自我报告的种族（非西班牙裔黑人或非西班牙裔白色）与信任的医生，医院，和健康保险plannes.Methods。受访者年龄18-75岁，被要求评价他们的信任程度的医生，健康保险计划，和医院。项目从医疗不信任指数被用来评估恐惧和怀疑hospital.Results.Responses进行了分析，为49（42%）非西班牙裔黑人和69（58%）非西班牙裔白色受访者（N= 118; 94%的总调查人口）。大多数受访者信任医生（71%）和医院（70%），但很少有人信任他们的医疗保险计划（28%）。调整潜在混杂因素后，非西班牙裔黑人受访者比非西班牙裔白色受访者更不可能信任他们的医生（调整后的绝对差异为37%; p= 0.01），更可能信任他们的健康保险计划（调整后的绝对差异为28%; p= 0.04）。对医院的信任差异（调整后的绝对差异为13%）无统计学意义。非西班牙裔黑人受访者比非西班牙裔白色受访者更有可能关注个人隐私和潜在的有害实验在hospital.Conclusions.模式的信任我们的医疗保健系统的组成部分不同的种族。信任的差异可能反映了黑人和白人不同的文化经历以及对护理的期望差异。如果要有效地提高患者获得护理的机会和对护理的满意度，就需要更好地了解这些因素。
Objective.A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans. While racial differences in trust in physicians have been demonstrated, little is known about racial variation in trust of health insurance plans and hospitals. For the present study, the authors analyzed responses to a cross-sectional telephone survey to assess the independent relationship of self-reported race (non-Hispanic black or non-Hispanic white) with trust in physicians, hospitals, and health insurance plans.Methods.Respondents ages 18–75 years were asked to rate their level of trust in physicians, health insurance plans, and hospitals. Items from the Medical Mistrust Index were used to assess fear and suspicion of hospitals.Results.Responses were analyzed for 49 (42%) non-Hispanic black and 69 (58%) non-Hispanic white respondents (N= 118; 94% of total survey population). A majority of respondents trusted physicians (71%) and hospitals (70%), but fewer trusted their health insurance plans (28%). After adjustment for potential confounders, non-Hispanic black respondents were less likely to trust their physicians than non-Hispanic white respondents (adjusted absolute difference 37%; p= 0.01) and more likely to trust their health insurance plans (adjusted absolute difference 28%; p= 0.04). The difference in trust of hospitals (adjusted absolute difference 13%) was not statistically significant. Non-Hispanic black respondents were more likely than non-Hispanic white respondents to be concerned about personal privacy and the potential for harmful experimentation in hospitals.Conclusions.Patterns of trust in components of our health care system differ by race. Differences in trust may reflect divergent cultural experiences of blacks and whites as well as differences in expectations for care. Improved understanding of these factors is needed if efforts to enhance patient access to and satisfaction with care are to be effective.