Differences in Patient-Reported Experiences of Care by Race and Acculturation Status
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ORIGINAL PAPER
Differences in Patient-Reported Experiences of Care by Race and Acculturation Status Memoona Hasnain • Alan Schwartz • Jorge Girotti • Angela Bixby • Luis Rivera • and the UIC Experiences of Care Project Group
Published online: 4 October 2012 Ó Springer Science+Business Media New York 2012
Abstract Patient-reported experiences of care are an important focus in health disparities research. This study explored the association of patient-reported experiences of care with race and acculturation status in a primary care setting. 881 adult patients (African-American 34 %; Hispanic—classified as unacculturated or biculturated— 31 %; Caucasian 33 %; missing race 2 %), in outpatient Family Medicine clinics, completed a written survey in Spanish or English. Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group (CAG) Survey Adult Primary Care instrument was used for experiences of care and Short Form-12 survey for health status. Controlling for other variables, race and acculturation were significantly associated with several CAG subscales. Hispanic patients gave significantly higher ratings for care experiences and expressed greater interest in shared decision making. Selected patient-reported measures of care are associated with patients’ race and acculturation status (for Hispanic patients). We discuss implications for both provision and measurement of quality care.
The UIC Experiences of Care Project Group consists of Alan Schwartz, Memoona Hasnain, Jorge Girotti, Angela Bixby, Bianca Castellano, Michelle M. Garrido, Marjorie A. Girotti, Joe Gomez, Ariel Leifer, Luis Rivera, Vamsi Vasireddy. M. Hasnain (&) A. Bixby L. Rivera Department of Family Medicine, College of Medicine, University of Illinois at Chicago, MC 663, 1919 W. Taylor Street, Chicago, IL 60612-7309, USA e-mail: [email protected] M. Hasnain A. Schwartz J. Girotti Department of Medical Education, University of Illinois at Chicago, Chicago, IL, USA
Keywords Patient-centered care Acculturation Cultural competence Quality care
Introduction Asking patients to rate the quality of their health care experiences is increasingly gaining emphasis in the ongoing evaluation of the provision of health care. Given persistent racial/ethnic disparities in health status in the United States, access to and utilization of health care, as well as the quality of care [1], it is crucial to explore differences in patients’ perception of the quality of care across ethnically diverse populations. These questions are particularly important when studies indicate that some non-white patients report better care experiences in situations where they are known to receive lower-quality care, while others do not [2–5]. One recent study [6] suggests both an important role for differential item use by respondents of different ethnicities and approaches to survey validation to measure and control for differential use, including varying response scales, measuring of patient expectations, and controlling for interrelated factors, such as e
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