Online Program

Impact of patient-provider race concordance on empowered decision-making among North Carolina Medicaid enrollees

Monday, November 4, 2013

Galen Smith III, PhD, Department of Political Science and Public Administration, University of North Carolina at Charlotte, Charlotte, NC
William P. Brandon, PhD, MPH, CPH, Department of Political Science & Public Administration, University of North Carolina Charlotte, Charlotte, NC
Keith Carnes, PhD, MHA, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
Cicily Hampton, PhD, Public Policy, University of North Carolina at Charlotte, Charlotte, NC
The race concordance hypothesis suggests that correspondence in race between patients and health providers improves a number of health-related outcomes, including communication, satisfaction, trust, and utilization of health services. Race concordance has also been linked to empowered decision-making by the recipients of health services. New data generated by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) 4.0 survey instrument enable the authors to examine the impact of race concordance on empowered decision-making in the white and black subpopulations of adult and child beneficiaries enrolled in North Carolina Medicaid's managed care network delivery system. The telephone survey was conducted in summer 2012. The dependent variable is a complex index derived from multiple survey items relevant to patient decision-making. The independent variable of interest is race concordance; several other variables (e.g., language concordance) serve as control variables. Propensity score matching controls for potential health care provider selection bias. Regression analysis seeks to reveal differences in empowered decision-making among concordant and discordant groups in the eight possible subpopulation combinations. The findings will be compared to similar studies of a 2006-2007 survey of N.C. Medicaid enrollees. The study findings will inform policymakers and other stakeholders committed to combating race-based disparities in health care.

Learning Areas:

Diversity and culture
Social and behavioral sciences

Learning Objectives:
Define the concepts of patient-provider race concordance and the race concordance hypothesis. Discuss the theoretical role that race concordance may play in empowered decision-making. Identify the eight race and age-based subpopulations subject to analysis in the study. Describe the conceptualization of the empowered decision-making variable. Describe the importance of the study findings, particularly in the context of reducing or eliminating race-based health disparities.

Keyword(s): Health Disparities, Decision-Making

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied the impact of race concordance on several health-related outcomes which have been published either as journal articles (forthcoming) or in the form of my doctoral dissertation. I have analyzed two separate iterations of the CAHPS-related survey data associated with this study's population that have spanned a period of seven years. In addition to the aforementioned publications, these analyses have resulted in the creation of several evaluation and policy reports.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.