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.
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At the suggestion of an anonymous reviewer, we also ran a series of regressions that included interaction terms for gender × ethnic category. For the “other providers overall” outcome only, one of these interaction terms (male × biculturated Hispanic) was significant (and negative), and the model with the interaction terms also demonstrated significant positive effects of male gender, unacculturated Hispanic, and biculturated Hispanic, along with the same patterns of coefficients for age, education, and SF-12 composites as in the main effects model. The marginal effect of being a biculturated Hispanic male in that model would be lower “other providers overall” ratings relative to other groups.
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This research was funded [in part] by grant number 63821 from the Robert Wood Johnson Foundation. Funding Source Grant number 63821 from the Robert Wood Johnson Foundation.
Conflict of interest
None of the authors have any conflict of interest to disclose.
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.
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Hasnain, M., Schwartz, A., Girotti, J. et al. Differences in Patient-Reported Experiences of Care by Race and Acculturation Status. J Immigrant Minority Health 15, 517–524 (2013). https://doi.org/10.1007/s10903-012-9728-x
- Patient-centered care
- Cultural competence
- Quality care