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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Donald A. Barr, MD, PhD, Department of Sociology, Stanford University, Building 120 MC 2047, Stanford, CA 94305-2047, 650 723-2884, barr@stanford.edu
Background: An expanding literature on racial and ethnic disparities in care suggests that, in certain circumstances, patients from ethnic minorities do not receive the same level of care as non-minority patients. The extent to which ethnic differences exist at the level of the primary care physician is not well understood. This study examines the extent to which patient responses to a commonly used patient satisfaction instrument differ based on the patient’s ethnicity. Methodology: Using the 9 Item Visit Satisfaction Questionnaire (VSQ-9) we conducted a survey of 517 primary care patients as they went through a primary care physician office visit. Patients generally were from affluent communities, were highly educated, and had full medical insurance. First controlling for patient demographics and organizational characteristics, we then entered patient ethnicity as a dichotomous white/non-white variable. Results: When using all nine items of the VSQ-9, which measure satisfaction with access to care, satisfaction with the quality of the physician-patient interaction, and overall satisfaction with the primary care visit, there was no difference in white/non-white satisfaction scores (p=.11). When we look only at patients’ satisfaction with the quality of the physician-patient interaction, we found that non-white patients were less satisfied with physician quality than white patients (p<.01). We repeated the analysis, using patient satisfaction with the quality of the interpersonal interaction with the non-physician staff, and found no difference between white and non-white patients (p=.42). Nearly all physicians in the study were white. The minority ethnic groups did not differ significantly in their average reported satisfaction. Conclusions: In a generally well educated and affluent community, non-white patients reported lower satisfaction with the quality of the interpersonal interaction with their primary care physician than comparable white patients seeing the same physicians. Ethnic differences were not found either in overall satisfaction with all aspects of care or satisfaction with the quality of the interpersonal interaction with non-physician staff. These results suggest that those medical care organizations that measure patient satisfaction as an indicator of quality of physician care should include patient ethnicity as a variable. The results are unable to distinguish whether lower satisfaction scores are due to different expectations and perceptions on the part of non-white patients, different patterns of treatment on the part of physicians, or a combination of both. Future research is essential to understand the sources of ethnically based differences in patient satisfaction with the care they receive from primary care physicians.
Learning Objectives: At the conclusion of the session, the participant will be able to
Keywords: Quality of Care, Minority Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.