Patient-physician racial concordance and the perceived quality and use of health care
Patient-physician racial concordance and the perceived quality and use of health care
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DOI：
10.1001/archinte.159.9.997
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发表时间：
1999-05-10
影响因子：
--
通讯作者：
Bindman, AB
中科院分区：
文献类型：
--
作者：
Saha, S;Komaromy, M;Bindman, AB
背景：来自种族和少数民族群体的患者使用较少的卫生保健服务，对他们的护理满意度低于来自多数白人人群的患者。这些差异可能部分归因于患者和医生之间的种族或文化差异。目的：了解患者和医生的种族一致性是否影响患者对医疗服务的满意度和使用。方法：我们分析了1994年联邦基金少数民族健康调查的数据，这是一项全国性的非机构成年人电话调查。对于2201名报告有定期医生的白人、黑人和西班牙裔受访者，我们检查了患者-医生种族一致性与患者对医生的评级、对医疗保健的满意度、报告的预防性护理接收情况和报告的所需医疗护理接收情况之间的关系。结果：黑人医生的黑人受访者比非黑人医生的黑人受访者更有可能将他们的医生评为优秀（调整优势比[OR]， 2.40； 95%置信区间[CI]， 1.55-3.72），并报告在前一年接受了预防性护理（调整优势比[OR]， 1.74; 95% CI, 1.01-2.98）和所有需要的医疗护理（调整优势比，2.94;95% CI, 1.10-7.87）。有西班牙裔医生的西班牙裔患者比有非西班牙裔医生的西班牙裔患者更有可能对他们的医疗保健总体感到非常满意（调整后OR为1.74,95% CI为1.01-2.99）。结论：我们的研究结果证实了种族和文化因素在医患关系中的重要性，并重申了黑人和西班牙裔医生在照顾黑人和西班牙裔患者中的作用。提高医生的文化能力可以提高少数民族人口的保健质量。与此同时，通过减少进入美国医生队伍的少数族裔人数，平权行动政策的逆转可能会对黑人和西班牙裔美国人的医疗保健服务产生不利影响。
Background: Patients from racial and ethnic minority groups use fewer health care services and are less satisfied with their care than patients from the majority white population. These disparities may be attributable in part to racial or cultural differences between patients and their physicians.Objective: To determine whether racial concordance between patients and physicians affects patients' satisfaction with and use of health care.Methods: We analyzed data from the 1994 Commonwealth Fund's Minority Health Survey, a nationwide, telephone survey of noninstitutionalized adults. For the 2201 white, black, and Hispanic respondents who reported having a regular physician, we examined the association between patient-physician racial concordance and patients' ratings of their physicians, satisfaction with health care, reported receipt of preventive care, and reported receipt of needed medical care.Results: Black respondents with black physicians were more likely than those with nonblack physicians to rate their physicians as excellent (adjusted odds ratio [OR], 2.40; 95% confidence interval [CI], 1.55-3.72) and to report receiving preventive care (adjusted OR, 1.74; 95% CI, 1.01-2.98) and all needed medical care (adjusted OR, 2.94; 95% CI, 1.10-7.87) during the previous year. Hispanics with Hispanic physicians were more likely than those with non-Hispanic physicians to be very satisfied with their health care overall (adjusted OR, 1.74, 95% CI, 1.01-2.99.Conclusions: Our findings confirm the importance of racial and cultural factors in the patient-physician relationship and reaffirm the role of black and Hispanic physicians in caring for black and Hispanic patients. Improving cultural competence among physicians may enhance the quality of health care for minority populations. In the meantime, by reducing the number of underrepresented minorities entering the US physician workforce, the reversal of affirmative action policies may adversely affect the delivery of health care to black and Hispanic Americans.