BACKGROUND: Racial and ethnic differences in patient health care experiences have not been well examined in the Veterans Affairs (VA) Healthcare System. OBJECTIVES: To examine racial/ethnic differences in outpatient health care experiences within and between VA medical facilities. RESEARCH DESIGN: We assessed within-facility and between-facility racial/ethnic differences in responses to the 2010 VA Survey of Healthcare Experiences of Patients using mixed-effects multinomial regression. SUBJECTS: A total of 211,459 respondents (53.2%) to a random survey of outpatients from 910 VA medical facilities (71.9% non-Hispanic white, 15.1% non-Hispanic black, 6.4% Hispanic, and 6.7% Other race/ethnicity). MEASURES: Negative and positive patient-reported experiences in 8 domains of health care. RESULTS: Between-facility effects for black race were higher for 7 domains of negative experiences [risk differences (RDs): 0.37% to 1.64%] and lower for 6 domains of positive experiences (RDs: -0.69% to -2.54%). Between-facility effects for Hispanic ethnicity were higher for 5 domains of negative experiences (RDs: 0.60%-1.34%) and lower for 5 domains of positive experiences (RDs: -1.00% to -1.88%). Hispanic ethnicity was also associated with higher within-facility rates of positive experiences for 5 domains of care (RDs: 2.97%-4.08%). Other race/ethnicity was associated with significantly higher within-facility rates of negative experiences (RDs: 2.04%-3.95%) and lower rates of positive experiences for all 8 domains (RDs: -2.05% to -4.70%). CONCLUSIONS: In a national random sample of Veterans managed in the VA Healthcare System, we demonstrated significant within-facility and between-facility racial and ethnic differences in outpatient health care experiences, with differing patterns for each minority group.
BACKGROUND: Racial and ethnic differences in patient health care experiences have not been well examined in the Veterans Affairs (VA) Healthcare System. OBJECTIVES: To examine racial/ethnic differences in outpatient health care experiences within and between VA medical facilities. RESEARCH DESIGN: We assessed within-facility and between-facility racial/ethnic differences in responses to the 2010 VA Survey of Healthcare Experiences of Patients using mixed-effects multinomial regression. SUBJECTS: A total of 211,459 respondents (53.2%) to a random survey of outpatients from 910 VA medical facilities (71.9% non-Hispanic white, 15.1% non-Hispanic black, 6.4% Hispanic, and 6.7% Other race/ethnicity). MEASURES: Negative and positive patient-reported experiences in 8 domains of health care. RESULTS: Between-facility effects for black race were higher for 7 domains of negative experiences [risk differences (RDs): 0.37% to 1.64%] and lower for 6 domains of positive experiences (RDs: -0.69% to -2.54%). Between-facility effects for Hispanic ethnicity were higher for 5 domains of negative experiences (RDs: 0.60%-1.34%) and lower for 5 domains of positive experiences (RDs: -1.00% to -1.88%). Hispanic ethnicity was also associated with higher within-facility rates of positive experiences for 5 domains of care (RDs: 2.97%-4.08%). Other race/ethnicity was associated with significantly higher within-facility rates of negative experiences (RDs: 2.04%-3.95%) and lower rates of positive experiences for all 8 domains (RDs: -2.05% to -4.70%). CONCLUSIONS: In a national random sample of Veterans managed in the VA Healthcare System, we demonstrated significant within-facility and between-facility racial and ethnic differences in outpatient health care experiences, with differing patterns for each minority group.
Authors: Audrey L Jones; Stefan G Kertesz; Leslie R M Hausmann; Maria K Mor; Ying Suo; Warren B P Pettey; James H Schaefer; Adi V Gundlapalli; Adam J Gordon Journal: J Subst Abuse Treat Date: 2020-02-29
Authors: Susan L Zickmund; Kelly H Burkitt; Shasha Gao; Roslyn A Stone; Audrey L Jones; Leslie R M Hausmann; Galen E Switzer; Sonya Borrero; Keri L Rodriguez; Michael J Fine Journal: J Gen Intern Med Date: 2018-01-08 Impact factor: 5.128
Authors: George L Jackson; Morris Weinberger; Miriam A Kirshner; Karen M Stechuchak; Stephanie D Melnyk; Hayden B Bosworth; Cynthia J Coffman; Brian Neelon; Courtney Van Houtven; Pamela W Gentry; Isis J Morris; Cynthia M Rose; Jennifer P Taylor; Carrie L May; Byungjoo Han; Christi Wainwright; Aviel Alkon; Lesa Powell; David Edelman Journal: Contemp Clin Trials Date: 2016-07-12 Impact factor: 2.226
Authors: Audrey L Jones; Maria K Mor; Gretchen L Haas; Adam J Gordon; John P Cashy; James H Schaefer; Leslie R M Hausmann Journal: J Gen Intern Med Date: 2018-06-08 Impact factor: 5.128
Authors: Audrey L Jones; Maria K Mor; John P Cashy; Adam J Gordon; Gretchen L Haas; James H Schaefer; Leslie R M Hausmann Journal: J Gen Intern Med Date: 2016-06-20 Impact factor: 5.128
Authors: Audrey L Jones; Leslie R M Hausmann; Gretchen L Haas; Maria K Mor; John P Cashy; James H Schaefer; Adam J Gordon Journal: Psychol Serv Date: 2017-05
Authors: Susan L Zickmund; Kelly H Burkitt; Shasha Gao; Roslyn A Stone; Keri L Rodriguez; Galen E Switzer; Judy A Shea; Nichole K Bayliss; Rebecca Meiksin; Mary B Walsh; Michael J Fine Journal: J Racial Ethn Health Disparities Date: 2015-01-21