RACIAL DISPARITIES: Whites Get Better Primary Care
A new study from the Johns Hopkins School of Public Health finds that patients of racial and ethnic minorities routinely receive inferior primary care compared to white patients. Minorities -- who are more likely to receive primary care in a hospital setting than from a private physician or clinic -- had more trouble getting appointments and waited longer to see a physician during appointments. Lead author Dr. Leiyu Shi, associate professor of health policy and management at Johns Hopkins, analyzed data on patients age 18 and over who had completed the Household Component of a 1997-98 Medical Expenditure Panel Survey, "a nationally representative survey of the U.S. civilian, noninstitutionalized population." He found that compared to whites, blacks and Hispanics were almost twice more likely to identify their primary health care provider as a hospital. Regarding a waiting period to see a physician, the study found that "minorities wailed longer to be seen during appointments than whites -- 22% to 28%" of minorities waited longer than 30 minutes, compared with 14% of whites. Hispanics were significantly less likely than whites to believe their primary physician listened to them, and Asians were less likely than whites to ask a primary care physician for a referral to a specialist. Of all the groups, Asians were the least satisfied with their interaction with health care staff. Nonetheless, the study found that ethnic differences did not significantly affect whether respondents had confidence in the abilities of their primary care physician or sought preventive information.
What to Do?
Dr. Shi calls for "increased efforts to provide ethnically and culturally competent care and remove the many barriers facing racial and ethnic minorities in their access to primary care," including assistance in transportation and child care, expansion of office hours, and reduction in waiting time. He said, "Simply expanding insurance coverage to previously uninsured minority patients, although helpful, may not overcome disparities in the qualitative experience of primary care among racial and ethnic groups." The study appears in the October issue of Medical Care (Johns Hopkins School of Public Health release, 10/4).