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October 2003, Vol 93, No. 10 | American Journal of Public Health 1713-1719
© 2003 American Public Health Association


RESEARCH AND PRACTICE

Patient–Physician Relationships and Racial Disparities in the Quality of Health Care

Somnath Saha, MD, MPH, Jose J. Arbelaez, MD, MHS and Lisa A. Cooper, MD, MPH

Somnath Saha is with the Section of General Internal Medicine, Portland Veterans Affairs Medical Center, Department of Veterans Affairs, and the Department of Medicine, Oregon Health & Science University, Portland, Ore. Jose J. Arbelaez is with the Welch Center for Prevention, Epidemiology, and Clinical Research, and the Division of General Internal Medicine, The Johns Hopkins University, Baltimore, Md. Lisa A. Cooper is with the Welch Center for Prevention, Epidemiology, and Clinical Research, the Division of General Internal Medicine, and the Department of Health Policy and Management, Bloomberg School of Public Health, The Johns Hopkins University.

Correspondence: Requests for reprints should be sent to Somnath Saha, Portland VAMC (P3MED), 3710 SW US Veterans Hospital Rd, Portland, OR 97239 (e-mail: sahas{at}ohsu.edu).

Objectives. This study explored whether racial differences in patient–physician relationships contribute to disparities in the quality of health care.

Methods. We analyzed data from The Commonwealth Fund’s 2001 Health Care Quality Survey to determine whether racial differences in patients’ satisfaction with health care and use of basic health services were explained by differences in quality of patient–physician interactions, physicians’ cultural sensitivity, or patient–physician racial concordance.

Results. Both satisfaction with and use of health services were lower for Hispanics and Asians than for Blacks and Whites. Racial differences in the quality of patient–physician interactions helped explain the observed disparities in satisfaction, but not in the use of health services.

Conclusions. Barriers in the patient–physician relationship contribute to racial disparities in the experience of health care.




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