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The Impact of Patient-Provider Race/Ethnicity Concordance on Provider Visits: Updated Evidence from the Medical Expenditure Panel Survey

Abstract

Objective

To examine the association between race/ethnicity concordance and in-person provider visits following the implementation of the Affordable Care Act.

Design

Using 2014–2015 data from the Medical Expenditure Panel Survey, we examine whether having a provider of the same race or ethnicity (“race/ethnicity concordance”) affects the probability that an individual will visit a provider. Multivariate probit models are estimated to adjust for demographic, socioeconomic, and health factors.

Results

Race/ethnicity concordance significantly increases the likelihood of seeking preventative care for Hispanic, African-American, and Asian patients relative to White patients (coef = 1.46, P < 0.001; coef = 0.71, P = 0.09; coef = 1.70, P < 0.001, respectively). Race/ethnicity concordance also increases the likelihood that Hispanic and Asian patients visit their provider for new health problems (coef = 2.14, P < 0.001 and coef = 1.49, P < 0.05, respectively). We find that race/ethnicity concordance is also associated with an increase in the likelihood that Hispanic and Asian patients continue to visit their provider for ongoing medical problems (Hispanic coef = 1.06, P < 0.001; Asian coef = 1.24, P < 0.05).

Conclusions

There is an association between race/ethnicity concordance and the likelihood of patients visiting their provider. Our results demonstrate that racial disparities in health care utilization may be partially explained by race/ethnicity concordance.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable written request.

References

  1. 1.

    Chen J, Vargas-Bustamante A, Mortensen K, Ortega AN. Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Med Care. 2016;54(2):140–6.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666.

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Traylor AH, Schmittdiel JA, Uratsu CS, Mangione CM, Subramanian U. Adherence to cardiovascular disease medications: does patient-provider race/ethnicity and language concordance matter? J Gen Intern Med. 2010a;25(11):1172–7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Traylor AH, Subramanian U, Uratsu CS, Mangione CM, Selby JV, Schmittdiel JA. Patient race/ethnicity and patient-physician race/ethnicity concordance in the management of cardiovascular disease risk factors for patients with diabetes. Diabetes Care. 2010b;33(3):520–5.

    Article  PubMed  Google Scholar 

  5. 5.

    Bleich SN, Simon AE, Cooper LA. Impact of patient–doctor race concordance on rates of weight-related counseling in visits by black and white obese individuals. Obesity. 2012;20(3):562–70.

    Article  PubMed  Google Scholar 

  6. 6.

    Ayanian JZ. The costs of racial disparities in health care. Harv Bus Rev. 2015.

  7. 7.

    Ford CL, Konrad TR, Godette DC, Corbie-Smith G. Acceptance of routine ELISA testing among black women STD patients: relationship to patient-provider racial concordance. Sex Transm Dis. 2008;35(3):211–3.

    Article  PubMed  Google Scholar 

  8. 8.

    LaVeist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;1:296–306.

    Article  Google Scholar 

  9. 9.

    LaVeist TA, Gaskin D, Richard P. Estimating the economic burden of racial health inequalities in the United States. International Journal of Health Services. 2011;41(2):231–8

  10. 10.

    Alcalá HE, Chen J, Langellier BA, Roby DH, Ortega AN. Impact of the Affordable Care Act on health care access and utilization among Latinos. J Am Board Fam Med. 2017;30(1):52–62.

    Article  PubMed  Google Scholar 

  11. 11.

    Chen J, Bustamante AV, Tom SE. Health care spending and utilization by race/ethnicity under the Affordable Care Act’s dependent coverage expansion. Am J Public Health. 2015;105(S3):S499–507.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Hernandez ND, Daley EM, Young L, Kolar SK, Wheldon C, Vamos CA, et al. HPV vaccine recommendations: does a health care provider’s gender and ethnicity matter to unvaccinated Latina college women? Ethn Health. 2017;22:1–7.

    Article  Google Scholar 

  13. 13.

    Jerant A, Bertakis KD, Fenton JJ, Tancredi DJ, Franks P. Patient-provider sex and race/ethnicity concordance: a national study of healthcare and outcomes. Med Care. 2011;1:1012–20.

    Article  Google Scholar 

  14. 14.

    Malhotra J, Rotter D, Tsui J, Llanos AA, Balasubramanian BA, Demissie K. Impact of patient–provider race, ethnicity, and gender concordance on cancer screening: findings from Medical Expenditure Panel Survey. Cancer Epidemiol Biomark Prev. 2017;26(12):1804–11.

    Article  Google Scholar 

  15. 15.

    Schoenthaler A, Allegrante JP, Chaplin W, Ogedegbe G. The effect of patient–provider communication on medication adherence in hypertensive black patients: does race concordance matter? Ann Behav Med. 2012;43(3):372–82.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Sweeney CF, Zinner D, Rust G, Fryer GE. Race/ethnicity and health care communication: does patient-provider concordance matter? Med Care. 2016;54(11):1005–9.

    Article  PubMed  Google Scholar 

  17. 17.

    Cooper-Patrick L, Gallo JJ, Gonzales JJ, Vu HT, Powe NR, Nelson C, et al. Race, gender, and partnership in the patient-physician relationship. JAMA. 1999;282(6):583–9.

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Gray B, Stoddard JJ. Patient-physician pairing: does racial and ethnic congruity influence selection of a regular physician? J Community Health. 1997;22(4):247–59.

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Jang Y, Yoon H, Kim MT, Park NS, Chiriboga DA. Preference for patient–provider ethnic concordance in Asian Americans. Ethn Health. 2018:1–12.

  20. 20.

    Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff. 2000;19(4):76–83.

    Article  CAS  Google Scholar 

  21. 21.

    Johnson RL, Roter D, Powe NR, Cooper LA. n. Am J Public Health. 2004;94(12):2084–90.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Phillips KL, Chiriboga DA, Jang Y. Satisfaction with care: the role of patient-provider racial/ethnic concordance and interpersonal sensitivity. J Aging Health. 2012;24(7):1079–90.

    Article  PubMed  Google Scholar 

  23. 23.

    Sohler NL, Fitzpatrick LK, Lindsay RG, Anastos K, Cunningham CO. Does patient–provider racial/ethnic concordance influence ratings of trust in people with HIV infection? AIDS Behav. 2007;11(6):884–96.

    Article  PubMed  Google Scholar 

  24. 24.

    Schoenthaler A, Montague E, Baier Manwell L, Brown R, Schwartz MD, Linzer M. Patient–physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence. Ethn Health. 2014;19(5):565–78.

    Article  PubMed  Google Scholar 

  25. 25.

    Shen MJ, Peterson EB, Costas-Muñiz R, Hernandez MH, Jewell ST, Matsoukas K, et al. The effects of race and racial concordance on patient-physician communication: a systematic review of the literature. J Racial Ethn Health Disparities. 2018;5(1):117–40.

    Article  PubMed  Google Scholar 

  26. 26.

    Van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40(1):1–140.

    Article  Google Scholar 

  27. 27.

    Cooper LA, Powe NR. Disparities in patient experiences, health care processes, and outcomes: the role of patient-provider racial, ethnic, and language concordance. New York: Commonwealth Fund; 2004. Jul 9

    Google Scholar 

  28. 28.

    Smedley BD, Stith AY, Nelson AR. 2003. Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal treatment: confronting racial and ethnic disparities in healthcare.

  29. 29.

    Meghani SH, Brooks JM, Gipson-Jones T, Waite R, Whitfield-Harris L, Deatrick JA. Patient–provider race-concordance: does it matter in improving minority patients’ health outcomes? Ethn Health. 2009;14(1):107–30.

    Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: a quasi-experimental study. Ann Intern Med. 2016;164(12):795–803.

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Rosenstock IM. Health belief model. In: Kazdin AE, editor. Encyclopedia of Psychology. Wahshington, DC: American Psychological Association; 2000. p. 78–80.

    Google Scholar 

  32. 32.

    Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q. 1988;15(2):175–83.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Alison Sanchez.

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Ma, A., Sanchez, A. & Ma, M. The Impact of Patient-Provider Race/Ethnicity Concordance on Provider Visits: Updated Evidence from the Medical Expenditure Panel Survey. J. Racial and Ethnic Health Disparities 6, 1011–1020 (2019). https://doi.org/10.1007/s40615-019-00602-y

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Keywords

  • Race concordance
  • Race/ethnicity concordance
  • Health care utilization
  • Racial disparities
  • Provider visits