RACIAL DIFFERENCES IN MEDICAL CARE SATISFACTION

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Recent research has focused on racial differences in the provision of medical care. In the last decade major surveys have found that African Americans are less satisfied than whites with the medical care that they receive. Dissatisfaction has important consequences for health behavior. It may result in lower rates of health care utilization, less compliance with physician recommendations, and poorer health outcomes. The sources of racial differences in satisfaction have not been investigated. The proposed research will determine some of the causes of the African American-white differences in satisfaction with medical care. There are three Specific Aims. Aim 1: To determine how racial differences in health care options contribute to differences in satisfaction with medical care. Racial differences in income and insurance status may lead to differences in satisfaction through lack of a usual source of care. Aim 2: To determine how racial differences in experience in the health care system contribute to differences in satisfaction with medical care. Discrimination in the medical encounter based on education, income and race may lead to lower rates of satisfaction among African Americans. Aim 3: To determine how racial differences in health status contribute to differences in health care satisfaction. Racial differences in both physical and psychological well-being may explain part of the differences in satisfaction. These Aims lead to three hypotheses. 1. Restricted health care options contribute to African Americans lower rates of satisfaction. 2. African Americans receive poorer treatment in medical encounters, thereby decreasing their satisfaction with care. 3. Poorer health status contributes to African Americans lower rates of satisfaction with medical care. These hypotheses will be tested using two methods. A quantitative analysis of the 1995 Detroit Area Study will determine which factors are statistically influential. Original focus group data will clarify the mechanisms by which these factors operate.