L Shi1. 1. Department of Health Policy and Management, Johns Hopkins School of Public Health and Hygiene, Baltimore, MD 21205-1996, USA. lshi@jhsph.edu
Abstract
OBJECTIVES: The purpose of this study was to examine the experience of primary care by racial and ethnic groups and identify aspects of primary care where significant disparities in experience exist across racial and ethnic groups. METHODS: Data for this study came from the Household Component of the 1997-1998 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the civilian noninstitutionalized population of the United States. Measures were identified within MEPS that denote race, ethnicity, experience of primary care, and socioeconomic covariates associated with access to care. RESULTS: Racial and ethnic minorities experienced worse primary care, particularly in the first-contact aspect, than did white Americans. Their usual sources of care were more likely to be hospital settings than private clinics. They faced greater barriers accessing their usual source of care (USC), finding it more difficult to get an appointment and waiting longer during an appointment. Many of the significant differences persist after adjustment for sociodemographic and health-status characteristics. CONCLUSIONS: Racial and ethnic disparity in primary care experience is not simply a reflection of sociodemographic and health-status differences across racial/ethnic groups. Efforts must be made to reduce nonfinancial as well as financial barriers to care and ensure that quality primary care is provided in all settings, public as well as private, and to individuals of all colors.
OBJECTIVES: The purpose of this study was to examine the experience of primary care by racial and ethnic groups and identify aspects of primary care where significant disparities in experience exist across racial and ethnic groups. METHODS: Data for this study came from the Household Component of the 1997-1998 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the civilian noninstitutionalized population of the United States. Measures were identified within MEPS that denote race, ethnicity, experience of primary care, and socioeconomic covariates associated with access to care. RESULTS: Racial and ethnic minorities experienced worse primary care, particularly in the first-contact aspect, than did white Americans. Their usual sources of care were more likely to be hospital settings than private clinics. They faced greater barriers accessing their usual source of care (USC), finding it more difficult to get an appointment and waiting longer during an appointment. Many of the significant differences persist after adjustment for sociodemographic and health-status characteristics. CONCLUSIONS: Racial and ethnic disparity in primary care experience is not simply a reflection of sociodemographic and health-status differences across racial/ethnic groups. Efforts must be made to reduce nonfinancial as well as financial barriers to care and ensure that quality primary care is provided in all settings, public as well as private, and to individuals of all colors.