Little is known about the influence of processes of hospital care on racial and ethnic differences in experiences with hospital care.
Subjects and methods
To determine whether patient experiences differed by race and ethnicity and whether these differences were associated with hospital care characteristics, we analyzed survey and hospital administrative data from 2664 adult patients after hospitalization at an urban teaching hospital during 1998–1999. We assessed the association of patient race and ethnicity with reporting problems in multiple dimensions of patient experience, using logistic regression to adjust for sex, age, self-reported health status, insurance status, income, route of hospital admission, and hospital service. We then stratified adjusted analyses by hospital service.
After adjustment for demographic and hospital characteristics, black (odds ratio (OR): 1.8; 95% confidence interval [CI]: 1.3–2.6) and Latino (OR: 2.0; 95% CI: 1.3–3.0) patients reported more problems with respect for their preferences compared to whites. Blacks reported more problems with respect for their preferences (OR: 1.7; 95% CI: 1.0–3.0) among patients discharged from surgical services, and Latinos reported more problems with respect for their preferences (OR:3.6; CI: 1.6–8.2) among patients discharged from obstetrical services when compared to whites. Patient experiences did not significantly differ by race among patients discharged from medical services.
We found significant racial and ethnic differences in patients’ experiences with hospital care, particularly in respect for patient preferences. Our findings suggest physicians and hospital staff should strive to understand and address the expectations of black and Latino patients, particularly those who are hospitalized for surgical or obstetrical issues.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Sociologic influences on decision-making by clinicians.Ann Intern Med. 1979; 90: 957-964
- White doctors and black patients.Pediatrics. 1985; 75: 639-643
- Physician race and care of minority and medically indigent patients.JAMA. 1995; 273: 1515-1520
- Race, gender, and partnership in the patient-physician relationship.JAMA. 1999; 282: 583-589
- Race, ethnicity, and the patient-caregiver relationship.Oncologist. 1999; 4: 325-331
- Disaggregating the effects of race on breast cancer survival.Fam Med. 1998; 30: 228-235
- Breast cancer.Black/White Cancer Survival Study Group. J Natl Cancer Inst. 1993; 85: 1129-1137
- Relationship between patient race and survival following admission to intensive care among patients of primary care physicians.Health Serv Res. 1991; 26: 531-542
- Effect of race on survival following in-hospital cardiopulmonary resuscitation.J Fam Pract. 1995; 40: 571-577
- The effect of patients’ preferences on racial differences in access to renal transplantation.N Engl J Med. 1999; 341: 1661-1669
- Racial differences in the use of revascularization procedures after coronary angiography.JAMA. 1993; 269: 2642-2646
- Minority cancer patients and their providers.Cancer. 2000; 88: 1929-1938
- End-of-life discussions and preferences among persons with HIV.JAMA. 2001; 285: 2880-2887
- Patients with schizophrenia at risk for excessive antipsychotic dosing.J Clin Psychiatry. 2000; 61: 344-348
- Discussion of hormone replacement therapy between physicians and their patients.Am J Med Qual. 2000; 15: 143-147
- Effect of race on the presentation and management of patients with acute chest pain.Ann Intern Med. 1993; 118: 593-601
- Patient characteristics associated with care by a cardiologist among adults hospitalized with severe congestive heart failure. SUPPORT Investigators.Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Coll Cardiol. 2000; 36: 2119-2125
- Patient satisfaction with hospital care.Medical Care. 2000; 38: 325-334
- The influence of patient sociodemographic characteristics on patient satisfaction.Military Med. 2000; 165: 72-76
- Medicare HMOs.Health Soc Policy. 2000; 12: 1-21
- Racial and ethnic differences in a patient survey.Med Care. 2000; 38: 300-310
- Evaluating the equivalence of health care ratings by whites and Hispanics.Med Care. 2000; 38: 517-527
- Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients.Med Care Res Rev. 2000; 57: 146-161
- Racial and ethnic disparities in perceptions of physician style and trust.Arch Fam Med. 2000; 9: 1156-1163
- Socioeconomic status and dissatisfaction among HMO enrollees.Med Care. 2000; 38: 508-516
- Are Latinos less satisfied with communication by health care providers?.J Gen Intern Med. 1999; 14: 409-417
- Impact of language barriers on patient satisfaction in an emergency department.J Gen Intern Med. 1999; 14: 82-87
- Patients evaluate their hospital care.Health Aff. 1991; 10: 254-267
- Direct observation of requests for clinical services in office practice.Arch Intern Med. 2003; 163: 1673-1681
- Patient trust in the physician.Fam Pract. 2002; 19: 476-483
- Unmet expectations for care and the patient-physician relationship.J Gen Intern Med. 2002; 17: 817-824
- The influence of gatekeeping and utilization review on patient satisfaction.J Gen Intern Med. 1999; 14: 287-296
- Adjusting for patient characteristics when analyzing reports from patients about hospital care.Med Care. 2001; 39: 635-641
- Parenteral analgesic and sedative use among ED patients in the United States.Am J Emerg Med. 2002; 20: 139-143
- Racial and ethnic differences in access to and use of health care services, 1977 to 1996.Med Care Res Rev. 2000; 57: 36-54
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.