Family Practice Advance Access originally published online on February 27, 2008
Family Practice 2008 25(1):49-55; doi:10.1093/fampra/cmn005
Effect of race on patient expectations regarding their primary care physicians
a Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
b The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
c Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical, Philadelphia, PA, USA
Correspondence to Carmen E. Guerra, University of Pennsylvania, 1221 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA; Email: carmen.guerra{at}uphs.upenn.edu. Karima Ravenell is currently at the University of Texas at Southwestern Medical Center, Dallas, TX, USA.
Received 23 March 2007; Revised 21 December 2007; Accepted 9 January 2008.
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Abstract |
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Background. Fulfilment of patients’ expectations has been associated with greater patient satisfaction with care and greater adherence to medical advice. However, little is know about how race influences patient expectations.
Objective. To determine the association between patient race and patient expectations of their primary care physician.
Methods. The design was a cross-sectional study. Setting and participants were sample of 709 primary care patients from four clinic sites at the Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania Health System. The measures were an expectations instrument asking patients to rate the necessity of the physician performing 13 activities during the index visit, self-reported race, demographics, the Rapid Estimate of Adult Literacy in Medicine, the Charlson Comorbidity Index and SF-12.
Results. After adjusting for age, sex, education, clinic site, comorbidity, health literacy and health status, African Americans were more likely to report it was absolutely necessary for the physician to refer them to a specialist [AOR 1.55 (95% confidence interval, CI, 1.09–2.21), P = 0.01], order tests [AOR 1.59 (95% CI 1.11–2.27), P = 0.01] and conduct each of the six physical exam components.
Conclusions. African American race is associated with greater expectations of the primary care physicians. More research is needed to confirm the differential expectations by race and determine the reasons for the differential expectations.
Keywords. Communication, expectations, health literacy, patient–physician relationships, race.
Guerra CE, McDonald VJ, Ravenell KL, Asch DA and Shea JA. Effect of race on patient expectations regarding their primary care physicians. Family Practice 2008; 25: 49–55.