Original Article

Journal of General Internal Medicine

, Volume 12, Issue 4, pp 237-242

First online:

Asian-American Patient Ratings of Physician Primary Care Performance

  • Deborah A. TairaAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts University
  • , Dana Gelb SafranAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts University
  • , Todd B. SetoAffiliated withCardiovascular Division, Beth Isreal Hospital
  • , William H. RogersAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts University
  • , Mark KosinskiAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts University
  • , John E. WareAffiliated withDepartment of Psychiatry, Tufts UniversityHarvard School of Public Health
  • , Naomi LiebermanAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts University
  • , Alvin R. TarlovAffiliated withThe Health Institute, New England Medical Center, Boston, Mass., Tufts UniversityDepartment of Medicine, Tufts University

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Abstract

OBJECTIVE: To examine how Asian-American patients' ratings of primary care performance differ from those of whites, Latinos, and African-Americans. DESIGN: Retrospective analyses of data collected in a cross-sectional study using patient questionnaires. SETTING: University hospital primary care group practice. PARTICIPANTS: In phase 1, successive patients who visited the study site for appointments were asked to complete the survey. In phase 2, successive patients were selected who had most recently visited each physician, going back as far as necessary to obtain 20 patients for each physician. In total, 502 patients were surveyed, 5% of whom were Asian-American. MAIN RESULTS: After adjusting for potential confounders, Asian-Americans rated overall satisfaction and 10 of 11 scales assessing primary care significantly lower than whites did. Dimensions of primary care that were assessed include access, comprehensiveness of care, integration, continuity, clinical quality, interpersonal treatment, and trust. There were no differences for the scale of longitudinal continuity. On average, the rating scale scores of Asian-Americans were 12 points lower than those of whites (on 100-point scales). CONCLUSIONS: We conclude that Asian-American patients rate physician primary care performance lower than do whites, African-Americans, and Latinos. Future research needs to focus on Asian-Americans to determine the generalizability of these findings and the extent to which they reflect differences in survey response tendencies or actual quality differences.