Title

Race, Gender, and Language Concordance in the Primary Care Setting

Document Type

Article

Publication Date

6-12-2009

Description

Purpose - The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care. Design/methodology/approach - The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported. Findings - Adjusting for covariates, the following items remained statistically significant: race -choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender - choosing primary care physician as USC and USC having office hours; and language - lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted, Research limitations/implications - While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross-sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups. Practical implications - This study indicates that more research is needed in this area to determine future resource allocation and policy direction. Originality/value - The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

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