Racial and ethnic differences in a patient survey: Patients' values, ratings, and reports regarding physician primary care performance in a large Health Maintenance Organization

Jann Murray-Garcia, Joe V. Selby, Julie Schmittdiel, Kevin Grumbach, Charles P. Quesenberry

Research output: Contribution to journalArticle

182 Citations (Scopus)

Abstract

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 whites. 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.

Original languageEnglish (US)
Pages (from-to)300-310
Number of pages11
JournalMedical Care
Volume38
Issue number3
StatePublished - Mar 2000

Fingerprint

Health Maintenance Organizations
Primary Care Physicians
rating
physician
organization
ethnicity
health
performance
Values
Primary Health Care
health promotion
medical care
Quality of Health Care
Health Promotion
Physicians
Hispanic Americans
patient care
Surveys and Questionnaires
confidence
Health

Keywords

  • African Americans
  • Asian Americans
  • Health care quality
  • Hispanics
  • Minority populations
  • Patient satisfaction
  • Patient-physician relationship
  • Primary care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Racial and ethnic differences in a patient survey : Patients' values, ratings, and reports regarding physician primary care performance in a large Health Maintenance Organization. / Murray-Garcia, Jann; Selby, Joe V.; Schmittdiel, Julie; Grumbach, Kevin; Quesenberry, Charles P.

In: Medical Care, Vol. 38, No. 3, 03.2000, p. 300-310.

Research output: Contribution to journalArticle

@article{80cf67c575074dceadcf4d532fe14a92,
title = "Racial and ethnic differences in a patient survey: Patients' values, ratings, and reports regarding physician primary care performance in a large Health Maintenance Organization",
abstract = "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 whites. 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.",
keywords = "African Americans, Asian Americans, Health care quality, Hispanics, Minority populations, Patient satisfaction, Patient-physician relationship, Primary care",
author = "Jann Murray-Garcia and Selby, {Joe V.} and Julie Schmittdiel and Kevin Grumbach and Quesenberry, {Charles P.}",
year = "2000",
month = "3",
language = "English (US)",
volume = "38",
pages = "300--310",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Racial and ethnic differences in a patient survey

T2 - Patients' values, ratings, and reports regarding physician primary care performance in a large Health Maintenance Organization

AU - Murray-Garcia, Jann

AU - Selby, Joe V.

AU - Schmittdiel, Julie

AU - Grumbach, Kevin

AU - Quesenberry, Charles P.

PY - 2000/3

Y1 - 2000/3

N2 - 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 whites. 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.

AB - 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 whites. 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.

KW - African Americans

KW - Asian Americans

KW - Health care quality

KW - Hispanics

KW - Minority populations

KW - Patient satisfaction

KW - Patient-physician relationship

KW - Primary care

UR - http://www.scopus.com/inward/record.url?scp=0034146233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034146233&partnerID=8YFLogxK

M3 - Article

C2 - 10718355

AN - SCOPUS:0034146233

VL - 38

SP - 300

EP - 310

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 3

ER -