Asian-American Patient Ratings of Physician Primary Care Performance

Taira, Deborah A.; Safran, Dana Gelb; Seto, Todd B.; Rogers, William H.; Kosinski, Mark; Ware, John E.; Lieberman, Naomi; Tarlov, Alvin R.

doi:10.1046/j.1525-1497.1997.012004237.x

Cited by 43 publications

(40 citation statements)

References 17 publications

(2 reference statements)

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“…This difference may be related to response frame. Asian Americans, in general, tend to assign lower scores on physician-rating questionnaires than whites, Latinos, or African Americans [50][51][52] ; perhaps Asians from other countries respond with lower scores than those living in the United States. Japanese, in particular, may hesitate to express strong feelings of positive or negative trust because of cultural inhibitions.…”

Section: Discussionmentioning

confidence: 99%

Trust in One's Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans

Tarn

Meredith²,

Kagawa‐Singer³

et al. 2005

The Annals of Family Medicine

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PURPOSE Trust is a cornerstone of the physician-patient relationship. We investigated the relation of patient characteristics, religiosity, acculturation, physician ethnicity, and insurance-mandated physician change to levels of trust in Japanese American and Japanese patients.METHODS A self-administered, cross-sectional questionnaire in English and Japanese (completed in the language of their choice) was given to community-based samples of 539 English-speaking Japanese Americans, 340 Japanese-speaking Japanese Americans, and 304 Japanese living in Japan.RESULTS Eighty-seven percent of English-speaking Japanese Americans, 93% of Japanese-speaking Japanese Americans, and 58% of Japanese living in Japan responded to trust items and reported mean trust scores of 83, 80, and 68, respectively, on a scale ranging from 0 to 100. In multivariate analyses, Englishspeaking and Japanese-speaking Japanese American respondents reported more trust than Japanese respondents living in Japan (P values <.001). Greater religiosity (P <.001), less desire for autonomy (P <.001), and physician-patient relationships of longer duration (P <.001) were related to increased trust. Among Japanese Americans, more acculturated respondents reported more trust (P <.001), and Japanese physicians were trusted more than physicians of another ethnicity. Among respondents prompted to change physicians because of insurance coverage, the 48% who did not want to switch reported less trust in their current physician than in their former physician (mean score of 82 vs 89, P <.001).CONCLUSIONS Religiosity, autonomy preference, and acculturation were strongly related to trust in one's physician among the Japanese American and Japanese samples studied and may provide avenues to enhance the physician-patient relationship. The strong relationship of trust with patient-physician ethnic match and the loss of trust when patients, in retrospect, report leaving a preferred physician suggest unintended consequences to patients not able to continue with their preferred physicians. INTRODUCTIONT rust between a patient and physician is a cornerstone of the patientphysician relationship.1,2 Trust can facilitate health information exchange, 3 as well as determine a patient' s willingness to seek care, 3,4 receptivity to health promotion counseling, 5-7 openness to examination and treatment, 4,5,[7][8][9][10][11] and likelihood of return for follow-up care. 5,10 Patients with more trust in their physician are likely to be more satisfi ed with care 5,[11][12][13][14] and to have positive clinical outcomes. 5,9,11 In recent years, patient trust has been challenged by perceived confl icts of interest inherent in managed Derjung M. Tarn, MD, MS 1 Lisa S. Meredith, PhD 2 Marjorie Kagawa-Singer, RN, PhD 3 Shinji Matsumura, MD, MSHS 4 Seiji Bito, MD, MSHS 5 Robert K. Oye, MD 6 Honghu Liu, PhD 6 Katherine L. Kahn, MD 6 Shunichi Fukuhara, MD 7 Neil S. Wenger, MD, MPH 8,[15][16][17][18][19][20] and by societal changes lea...

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Section: Discussionmentioning

confidence: 99%

Trust in One's Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans

Tarn

Meredith²,

Kagawa‐Singer³

et al. 2005

The Annals of Family Medicine

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“…A number of studies show that Asian Americans and Hispanics tend to report lower levels of satisfaction with their health care than whites and African Americans (Taira et al 1997;Murray-Garcia et al 2000;Snyder et al 2000;Morales et al 2001). Language and cultural differences between enrollees and medical care providers appear to be important determinants of the gap in satisfaction and have likely implications for quality of care (Woloshin et al 1995;Rivadeneyra et al 2000).…”

Section: Disenrollment As a Proxy For Enrollee Satisfactionmentioning

confidence: 99%

Health Plan Disenrollment in a Choice-Based Medicaid Managed Care Program

Buchmueller¹,

Gilmer²,

Harris³

2004

INQUIRY

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Health Plan Disenrollment in a Choice-Based Medicaid Managed Care ProgramConsumer decisions to switch health plans have implications for quality of care and risk selection. We examine factors related to time to disenrollment in a Medicaid managed care program where beneficiaries face a menu of plans and can change plans every month. Several findings have direct policy relevance. Families and individuals who make active choices upon entering the program are at substantially lower risk of disenrollment than those who are auto-assigned. Interactions between enrollee ethnicity and provider language proficiency suggest that enrollee satisfaction depends on the cultural competence of providers. Differential disenrollment by risk status results in adverse retention for certain types of plans.

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“…[11][12][13][14] One study of employer-based health insurance (160,694 participants: 83% White, 8% Black, 6% Hispanic, 3% Asian) sought to measure satisfaction with health care by soliciting answers in these domains: receiving needed care; receiving care quickly; doctor communication; helpfulness of office staff; and customer service. 11 Blacks, Hispanics and Asians reported lack of satisfaction with different aspects of their health care.…”

Section: Discussionmentioning

confidence: 99%

Cultural implications of filial obligation and the Asian Indian American family caregiver

Baldwin¹,

Pope²,

Marks³

2017

Qual Res Med Healthc

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Family caregivers in young adulthood from different racial/ethnic groups represent an understudied population. Of this group, Asian Indians are a diverse and fast-growing immigrant population in the US and present unique challenges for health care providers. To illustrate factors influencing a young family caregiver from an under-represented racial/ethnic population, we report on the case of a 33 year-old American from an Asian Indian background who was a caregiver for his father with Normal Pressure Hydrocephalus (NPH). With this case report, we illustrate that medical providers should attend to cultural norms of the family system, including family communication patterns, filial obligation, and decision-making.

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Asian-American Patient Ratings of Physician Primary Care Performance

Cited by 43 publications

References 17 publications

Trust in One's Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans

Trust in One's Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans

Health Plan Disenrollment in a Choice-Based Medicaid Managed Care Program

Cultural implications of filial obligation and the Asian Indian American family caregiver

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