Objective: To estimate the prevalence and impact of perceived racial/ethnic discrimination on health care delivery for Medicaid patients. Study Design: Telephone survey of 386 randomly selected African Americans and 305 whites with Medicaid insurance from metropolitan areas in eastern, central, and western Michigan. Results: The rates of perceived racial/ethnic discrimination while receiving health care were 12% for African Americans and 6% for whites. Nurses were identified most frequently (9%) as the source of discrimination followed by physicians (7%) and the health plan (4%). African Americans were less likely to report racial/ethnic discrimination when receiving substance abuse care than when receiving general medical care, mental health care, or home care. Respondents who experienced discrimination were significantly less satisfied with their overall care. This effect was independent of race. The perception that the primary care physician was caring was the single most important determinant of patient satisfaction. Race had no independent impact on the perception of how much the physician cared about patient well-being. Race also had no independent impact on patient satisfaction with the health plan. There were no significant differences between managed care plans and fee-for-service plans in any of the measurements. Conclusion: Experience with perceived racial/ethnic discrimination, not minority racial status per se, causes patient dissatisfaction and interferes with the patient-physician relationship for Medicaid patients.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Understand the negative impact of racial/ethnic discrimination in the delivery of health care to patients on medicaid. 2. Identify and assess racial/ethnic discrimination in various health care settings. 3. Take steps to reduce or eliminate racial/ethnic discrimination in their own health care environment
Keywords: Ethnic Minorities, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.