Do patient assessments of primary care differ by patient ethnicity?

Health Serv Res. 2001 Dec;36(6 Pt 1):1059-71.


Objective: To determine if patient assessments (reports and ratings) of primary care differ by patient ethnicity.

Data sources/study design: A self-administered patient survey of 6,092 Massachusetts employees measured seven defining characteristics of primary care: (1) access (financial, organizational); (2) continuity (longitudinal, visit based); (3) comprehensiveness (knowledge of patient, preventive counseling); (4) integration; (5) clinical interaction (communication, thoroughness of physical examinations); (6) interpersonal treatment; and (7) trust. The study employed a cross-sectional observational design.

Principal findings: Asians had the lowest primary care performance assessments of any ethnic group after adjustment for socioeconomic and other factors. For example, compared to whites, Asians had lower scores for communication (69 vs. 79, p = .001) and comprehensive knowledge of patient (56 vs. 48, p = .002), African Americans and Latinos had less access to care, and African Americans had less longitudinal continuity than whites.

Conclusions: We do not know what accounts for the observed differences in patient assessments of primary care. The fact that patient reports as well as the more subjective ratings of care differed by ethnicity suggests that quality differences might exist that need to be addressed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / psychology*
  • Asian Americans / psychology*
  • Attitude to Health / ethnology*
  • Communication
  • Continuity of Patient Care / economics
  • Continuity of Patient Care / standards
  • Cross-Sectional Studies
  • European Continental Ancestry Group / psychology*
  • Female
  • Health Care Surveys
  • Health Services Accessibility / economics
  • Health Services Accessibility / standards
  • Hispanic Americans / psychology*
  • Humans
  • Male
  • Massachusetts
  • Middle Aged
  • Physical Examination / standards
  • Physician-Patient Relations
  • Primary Health Care / economics
  • Primary Health Care / standards*
  • Quality of Health Care*
  • Socioeconomic Factors
  • Surveys and Questionnaires