Racial and ethnic disparities in perceptions of physician style and trust.

M P Doescher, B G Saver, P Franks, K Fiscella
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引用次数: 595

Abstract

Context: While pervasive racial and ethnic inequalities in access to care and health status have been documented, potential underlying causes, such as patients' perceptions of their physicians, have not been explored as thoroughly.

Objective: To assess whether a person's race or ethnicity is associated with low trust in the physician.

Design, setting, and participants: Data were obtained from the 1996 through 1997 Community Tracking Survey, a nationally representative sample. Adults who identified a physician as their regular provider and had at least 1 physician visit in the preceding 12 months were included (N = 32,929).

Main outcome measure: Patients' ratings of their satisfaction with the style of their physician and their trust in physicians. The Satisfaction With Physician Style Scale measured respondents' perceptions of their physicians' listening skills, explanations, and thoroughness. The Trust in Physician Scale measured respondents' perceptions that their physicians placed the patients' needs above other considerations, referred the patient when needed, performed unnecessary tests or procedures, and were influenced by insurance rules.

Results: After adjustment for socioeconomic and other factors, minority group members reported less positive perceptions of physicians than whites on these 2 conceptually distinct scales. Minority group members who lacked physician continuity on repeat clinic visits reported even less positive perceptions of their physicians on these 2 scales than whites.

Conclusions: Patients from racial and ethnic minority groups have less positive perceptions of their physicians on at least 2 important dimensions. The reasons for these differences should be explored and addressed. Arch Fam Med. 2000;9:1156-1163

对医生风格和信任认知的种族和民族差异。
背景:虽然在获得护理和健康状况方面普遍存在的种族和族裔不平等现象已被记录在案,但潜在的根本原因,如患者对医生的看法,尚未得到彻底的探讨。目的:评估一个人的种族或民族是否与对医生的低信任度有关。设计、设置和参与者:数据来自1996年至1997年的社区跟踪调查,这是一个具有全国代表性的样本。在过去的12个月里,至少有1次医生就诊的成年人(N = 32929)被纳入研究对象。主要结果测量:患者对其医生风格的满意度评分和对医生的信任。对医生风格的满意度量表测量了受访者对医生倾听技巧、解释和彻彻性的看法。“对医生的信任”量表衡量了答复者的看法,即他们的医生将患者的需求置于其他考虑之上,在需要时转诊患者,进行不必要的检查或程序,并受到保险规则的影响。结果:在对社会经济和其他因素进行调整后,在这两个概念上不同的量表上,少数族裔成员对医生的积极看法低于白人。在重复就诊中缺乏医生连续性的少数群体成员在这两个量表上对医生的正面评价甚至低于白人。结论:来自种族和少数民族群体的患者在至少2个重要维度上对他们的医生有较少的积极看法。应该探讨和解决造成这些差异的原因。中华医学杂志。2000;9:1156-1163
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