Does Patient-Centered Care Affect Racial Disparities in Health?

Health care delivery;Race interaction terms;Pay-for-performance;Health policy

Slade, Catherine Putnam ; Public Policy

University:Georgia Institute of Technology

Department:Public Policy

关键词: Health care delivery;    Race interaction terms;    Pay-for-performance;    Health policy;   

Others  :  https://smartech.gatech.edu/bitstream/1853/22569/1/slade_catherine_p_200804_phd.pdf

美国|英语

来源: SMARTech Repository

【 摘 要 】

This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution.While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.