Racial and ethnic differences in a patient survey -: Patients' values, ratings, and reports regarding physician primary care performance in a large health maintenance organization
Racial and ethnic differences in a patient survey -: Patients' values, ratings, and reports regarding physician primary care performance in a large health maintenance organization
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DOI：
10.1097/00005650-200003000-00007
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发表时间：
2000-03-01
期刊：
影响因子：
3
通讯作者：
Quesenberry, CP
中科院分区：
文献类型：
--
作者：
Murray-García, JL;Selby, JV;Quesenberry, CP
背景。很少有研究调查种族和/或民族对患者护理质量评分的影响。在评估这些可能的差异时，没有人考虑到患者对医疗护理的价值观和信念。我们探讨了患者对医生初级保健表现的价值观、评分和报告是否因种族和/或民族而异。研究设计。这是一项横断面邮寄患者调查。研究对象是大型健康维护人群中的成年初级保健患者（7747名白人，836名黑人，710名拉丁裔和1007名亚洲人）。措施和方法。对初级保健的以下方面进行了评估：技术能力、沟通、可及性、预防和健康促进以及总体满意度。测量了患者在这些方面的价值观和他们对医疗保健的信心。多变量分析显示种族/民族与满意度和接受预防服务的报告之间存在关联。在被测量的初级保健的10个维度中，亚洲人对医生表现的评价明显低于白人，包括亚裔亚群体之间的差异。拉丁美洲人对医生可及性的评价不如白人。黑人对医生的社会心理和生活方式健康促进实践的评价高于白人。在接受预防服务的患者报告中没有发现差异，除了太平洋岛民报告接受的预防服务明显多于白人。在大型HMO人群中，患者对初级保健的满意度在种族和民族以及亚洲族裔亚群之间存在显著差异。这些发现可能代表了护理质量的实际差异或患者感知、患者期望和/或问卷回答方式的差异。需要进行更多的研究，以准确和文化上适当的方式评估健康计划是否满足所有参保人的需求。
BACKGROUND. Few studies have investigated the influence of race and/or ethnicity on patients' ratings of quality of care. None have incorporated patients' values and beliefs regarding medical care in assessing these possible differences.OBJECTIVES. We explored whether patients' values, ratings, and reports regarding physicians' primary care performance differed by race and/or ethnicity.RESEARCH DESIGN. This was a cross-sectional, mailed patient survey.SUBJECTS. The study subjects were adult primary care patients in a large health maintenance population (7,747 whites, 836 blacks, 710 Latinos, and 1,007 Asians).MEASURES AND METHODS. Ratings of the following dimensions of primary care were measured: technical competence, communication, accessibility, prevention and health promotion, and overall satisfaction. Patients' values regarding these dimensions and their confidence in medical care were measured. Multivariate analyses yielded associations of race/ethnicity with satisfaction and with reports of prevention services received.RESULTS. For 7 of the 10 dimensions of primary care measured, Asians rated physician performance significantly less favorably than did whites, including differences among Asian ethnic subgroups. Latinos rated physicians' accessibility less favorably than did whites. Blacks rated physicians' psychosocial and lifestyle health promotion practices higher than did whiles. No differences were found in patient reports of prevention services received, except pacific Islanders reported receiving significantly more prevention services than whites.CONCLUSIONS. In a large HMO population, significant differences were found by race and ethnicity, and among Asian ethnic subgroups, in levels of patient satisfaction with primary care. These findings may represent actual differences in quality of care or variations in patient perceptions, patient expectations, and/or questionnaire response styles. More research is needed to assess, in accurate and culturally appropriate ways, whether health plans are meeting the needs of all enrollees.