The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes

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• 作者：David M. Cykert^a ; ^b ; ^{david.cykert@gmail.com} ; Joni S. Williams^a ; ^b ; ^{stromjl@musc.edu} ; Rebekah J. Walker^a ; ^b ; ^c ; ^{walkerrj@musc.edu} ; Kimberly S. Davis^b ; ^{davisks@musc.edu} ; Leonard E. Egede^a ; ^b ; ^c ; ^{egedel@musc.edu}
• 关键词：Cumulative discrimination ; Quality of care ; Patient-centered care ; Dissatisfaction with care ; Adults ; Diabetes
• 刊名：Journal of Diabetes and its Complications
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：31
• 期：1
• 页码：175-179
• 全文大小：252 K
• 卷排序：31

文摘

Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patient-centeredness, and dissatisfaction with care in adults with type 2 diabetes.MethodsSix hundred two patients from two primary care clinics in Charleston, SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care. The models control for race, site, age, gender, marital status, duration of diabetes, education, hours worked weekly, income, and health status.ResultsThe mean age was 61.5 years, with 66.3% non-Hispanic blacks, and 41.9% earning less than $20,000 annually. In final adjusted analyses, lower patient-centered care was associated with a higher discrimination score (β = − 0.28; p = 0.006), reporting at least 1 category of discrimination (β = − 1.47; p = 0.002), and reporting at least 2 categories of discrimination (β = − 1.34; p = 0.004). Dissatisfaction with care was associated with at least 2 categories of discrimination (β = 0.45; p = 0.002). No significant associations were seen with quality of care indicators.ConclusionsIncreased cumulative discrimination was associated with decreased feeling of patient-centeredness and increased dissatisfaction with care. However, these perceptions of discrimination were not significantly associated with quality indicators.