Provider Factors and Patient-Reported Healthcare Discrimination in the Diabetes Study of California (DISTANCE)

Details

• Personal Author:
  Adler N ; Grembowski D ; Karter AJ ; Lyles CR ; Schillinger D ; Spigner C ; Young BA
• Description:
  Objective: We examined provider-level factors and reported discrimination in the healthcare setting. Methods With data from the Diabetes Study of Northern California (DISTANCE) - a race-stratified survey of diabetes patients in Kaiser Permanente Northern California - we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables, including racial concordance. Results: Subjects (n = 12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2-8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR = 0.09; 95% CI: 0.01-0.67) and those rating their provider higher on communication (OR = 0.70; 95% CI: 0.66-0.74) were less likely to report discrimination, while those with more visits (OR = 1.10; 95% CI: 1.03-1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity. Conclusions: Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination. Practice implications: Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment. [Description provided by NIOSH]
• Subjects:
  Blood Healthcare Disparities Hematologic Diseases Minority Health Occupational Health Race Factors Safety
• Keywords:
  Author Keywords: Race/Ethnicity Blood Sugar Disorders Diabetes Care Discrimination Health Care Health Disparities Managed Care Minority Health Provider Factors Racial Factors
• ISSN:
  0738-3991
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 10 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  85
• Issue:
  3
• NIOSHTIC Number:
  nn:20056916
• Citation:
  Patient Educ Couns 2011 Dec; 85(3):e216-e224
• Contact Point Address:
  Courtney Rees, Department of Health Services, University of Washington School of Public Health, Box 359455, Seattle, WA 98195, USA
• Email:
  crees@u.washington.edu
• Federal Fiscal Year:
  2012
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Patient Education and Counseling
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ea705904f6fbf40108e1e2cc8682300afc5af90b6c2c074119a9713f27bcc316594f83554ba4538a848630178b3bd90316d21da3f14131b9e46d02cf2134bc7d
• Download URL:
  https://stacks.cdc.gov/view/cdc/214409/cdc_214409_DS1.pdf
• File Type:
  [PDF - 331.52 KB ]