Differences in Patient-Reported Experiences of Care by Race and Acculturation Status
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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.
- Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. Washington: National Academy Press; 2002.
- Lurie N, Zhan C, Sangl J, Bierman AS, Sekscenski ES. Variation in racial and ethnic differences in consumer assessments of health care. Am J Manag Care. 2003;9(7):502–9.
- Weech-Maldonado R, Morales LS, Elliott M, Spritzer K, Marshall G, Hays RD. Race/ethnicity, language, and patients’ assessments of care in Medicaid managed care. Health Serv Res. 2003;38(3):789–808. CrossRef
- Weech-Maldonado R, Elliott MN, Morales LS, Spritzer K, Marshall GN, Hays RD. Health plan effects on patient assessments of Medicaid managed care among racial/ethnic minorities. J Gen Intern Med. 2004;19(2):136–45. CrossRef
- Dayton E, Zhan C, Sangl J, Darby C, Moy E. Racial and ethnic differences in patient assessments of interactions with providers: disparities or measurement biases? Am J Med Qual. 2006;21(2):109–14. CrossRef
- Hausmann LR, Kressin NR, Hanusa BH, Ibrahim SA. Perceived racial discrimination in health care and its association with patients’ healthcare experiences: does the measure matter? Ethn Dis. 2010;20(1):40–7.
- Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97. CrossRef
- Cheng EM, Chen A, Cunningham W. Primary language and receipt of recommended health care among Hispanics in the United States. J Gen Intern Med. 2007;22(Suppl 2):283–8. CrossRef
- DuBard CA, Gizlice Z. Language spoken and differences in health status, access to care, and receipt of preventive services among US Hispanics. Am J Public Health. 2008;98(11):2021–8. CrossRef
- Ghaddar S, Brown CJ, Pagán JA, Díaz V. Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities. Rev Panam Salud Publica. 2010;28(3):190–7. CrossRef
- Ward KK, Roncancio AM, Berenson AB. Cultural adaptation among Hispanic women as related to awareness and acquisition of emergency contraception. Contraception. 2010;82(6):534–7. CrossRef
- Lorenzo-Blanco EI, Unger JB, Ritt-Olson A, Soto D, Baezconde-Garbanati L. Acculturation, gender, depression, and cigarette smoking among U.S. Hispanic youth: the mediating role of perceived discrimination. J Youth Adolesc. 2011;40(11):1519–33. CrossRef
- Gorman BK, Read JG, Krueger PM. Gender, acculturation, and health among Mexican Americans. J Health Soc Behav. 2010;51(4):440–57. CrossRef
- Pérez-Escamilla R, Garcia J, Song D. HEALTH CARE ACCESS AMONG HISPANIC IMMIGRANTS: ¿ALGUIEN ESTÁ ESCUCHANDO? [IS ANYBODY LISTENING?]. NAPA Bull. 2010;34(1):47–67. CrossRef
- Berdahl TA, Torres Stone RA. Examining Latino differences in mental healthcare use: the roles of acculturation and attitudes towards healthcare. Commun Ment Health J. 2009;45(5):393–403. CrossRef
- Zambrana RE, Carter-Pokras O. Role of acculturation research in advancing science and practice in reducing health care disparities among Latinos. Am J Public Health. 2010;100(1):18–23. CrossRef
- Solomon LS, Hays RD, Zaslavsky AM, Ding L, Cleary PD. Psychometric properties of a group-level Consumer Assessment of Health Plans Study (CAHPS) instrument. Med Care. 2005;43(1):53–60.
- Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33. CrossRef
- Marin G, Gamba RJ. A new measurement of acculturation for Hispanics: the Bidimensional Acculturation Scale for Hispanics (BAS). Hisp J Behav Sci. 1996;18(3):297–316. CrossRef
- Institute of Medicine: Committee on Health Care in America. Crossing the quality chasm: a new health system for the 21st century. National Academy Press; 2001.
- Katz JN, Lyons N, Wolff LS, Silverman J, Emrani P, Holt HL, Corbett KL, Escalante A, Losina E. Medical decision-making among Hispanics and non-Hispanic Whites with chronic back and knee pain: a qualitative study. BMC Musculoskelet Disord. 2011;21(12):78. CrossRef
- Antecol H, Bedard K. Unhealthy assimilation: why do immigrants converge to American health status levels? Demography. 2006;43(2):337–60. CrossRef
- Akresh IR, Frank R. Health selection among new immigrants. Am J Public Health. 2008;98(11):2058–64. CrossRef
- Diwan S. Limited English proficiency, social network characteristics, and depressive symptoms among older immigrants. J Gerontol B Psychol Sci Soc Sci. 2008;63(3):S184–91. CrossRef
- Johnson KL, Carroll JF, Fulda KG, Cardarelli K, Cardarelli R. Acculturation and self-reported health among Hispanics using a socio-behavioral model: the North Texas Healthy Heart Study. BMC Public Health. 2010;2(10):53. CrossRef
- Schwartz A, Hasnain M, Eiser AR, Lincoln E, Elstein AS. Patient-physician fit: an exploratory study of a multidimensional instrument. Med Decis Mak. 2006;26(2):122–33. CrossRef
- Differences in Patient-Reported Experiences of Care by Race and Acculturation Status
Journal of Immigrant and Minority Health
Volume 15, Issue 3 , pp 517-524
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
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- Patient-centered care
- Cultural competence
- Quality care
- Industry Sectors
- Author Affiliations
- 1. Department of Family Medicine, College of Medicine, University of Illinois at Chicago, MC 663, 1919 W. Taylor Street, Chicago, IL, 60612-7309, USA
- 2. Department of Medical Education, University of Illinois at Chicago, Chicago, IL, USA