BACKGROUND: Increasing patient-provider sex and race/ethnicity concordance has been proposed to improve healthcare and help mitigate health disparities, but the relationship between concordance and health outcomes remains unclear. OBJECTIVE: To examine associations of patient-provider sex, race/ethnicity, and dual concordance with healthcare measures. RESEARCH DESIGN AND PARTICIPANTS: Analyses of data from adult respondents indicating a usual source of healthcare (N=22,440) in the 2002 to 2007 Medical Expenditure Panel Surveys (each a 2-year panel). MEASURES: Year 1 provider communication, sex-neutral (colorectal cancer screening, influenza vaccination) and sex-specific (mammography, Papanicolaou smear, prostate-specific antigen) prevention; and year 2 health status (SF-12). Analyses adjusted for patient sociodemographics and health variables, and healthcare provider (usual source of care) sex and race/ethnicity. RESULTS: Of 24 concordance assessments, 3 were statistically significant. Women with female providers were more likely to report mammography adherence [average adjusted marginal effect=3.9%, 95% confidence interval (CI): 1.6%, 6.2%; P<0.01]. Respondents reporting dual concordance were less likely to rate provider communication in the highest quartile (average adjusted marginal effect =-4.2%, 95% CI: -8.1%, -0.2%; P=0.04), but dual concordance was associated with higher adjusted SF-12 Physical Component Summary scores (0.58 points, 95% CI: 0.00, 1.15; P=0.05). CONCLUSIONS: Little evidence of clinical benefit resulting from sex or race/ethnicity concordance was found. Greater matching of patients and providers by sex and race/ethnicity is unlikely to mitigate health disparities.
BACKGROUND: Increasing patient-provider sex and race/ethnicity concordance has been proposed to improve healthcare and help mitigate health disparities, but the relationship between concordance and health outcomes remains unclear. OBJECTIVE: To examine associations of patient-provider sex, race/ethnicity, and dual concordance with healthcare measures. RESEARCH DESIGN AND PARTICIPANTS: Analyses of data from adult respondents indicating a usual source of healthcare (N=22,440) in the 2002 to 2007 Medical Expenditure Panel Surveys (each a 2-year panel). MEASURES: Year 1 provider communication, sex-neutral (colorectal cancer screening, influenza vaccination) and sex-specific (mammography, Papanicolaou smear, prostate-specific antigen) prevention; and year 2 health status (SF-12). Analyses adjusted for patient sociodemographics and health variables, and healthcare provider (usual source of care) sex and race/ethnicity. RESULTS: Of 24 concordance assessments, 3 were statistically significant. Women with female providers were more likely to report mammography adherence [average adjusted marginal effect=3.9%, 95% confidence interval (CI): 1.6%, 6.2%; P<0.01]. Respondents reporting dual concordance were less likely to rate provider communication in the highest quartile (average adjusted marginal effect =-4.2%, 95% CI: -8.1%, -0.2%; P=0.04), but dual concordance was associated with higher adjusted SF-12 Physical Component Summary scores (0.58 points, 95% CI: 0.00, 1.15; P=0.05). CONCLUSIONS: Little evidence of clinical benefit resulting from sex or race/ethnicity concordance was found. Greater matching of patients and providers by sex and race/ethnicity is unlikely to mitigate health disparities.
Authors: Marjory Charlot; M Christina Santana; Clara A Chen; Sharon Bak; Timothy C Heeren; Tracy A Battaglia; A Patrick Egan; Richard Kalish; Karen M Freund Journal: Cancer Date: 2015-01-06 Impact factor: 6.860
Authors: Megan Johnson Shen; Emily B Peterson; Rosario Costas-Muñiz; Migda Hunter Hernandez; Sarah T Jewell; Konstantina Matsoukas; Carma L Bylund Journal: J Racial Ethn Health Disparities Date: 2017-03-08
Authors: Marilyn L Kwan; Emily K Tam; Isaac J Ergas; David H Rehkopf; Janise M Roh; Marion M Lee; Carol P Somkin; Anita L Stewart; Lawrence H Kushi Journal: Breast Cancer Res Treat Date: 2013-05-29 Impact factor: 4.872