Perceived discrimination in medical settings and perceived quality of care: A population-based study in Chicago

Abstract

Perceived discrimination in medical settings remains prevalent within the U.S. health care system. However, the details of these experiences and their associations with perceived quality of care are not well understood. Our study assessed multiple measures of perceived racial/ethnic discrimination in medical settings and investigated the locations and purported perpetrators of the discriminatory experiences within a population-based sample of 1,543 Black, White, Mexican, Puerto Rican, and Other adults. We used logistic regression to estimate associations between perceived discrimination in the medical setting and three quality of care indicators. Overall, 40% of the sample reported one or more types of perceived discrimination in a medical setting, with significant differences by race/ethnicity. Discrimination was perceived across health settings and from a variety of providers and staff. In adjusted logistic regression models, individuals reporting discrimination had more than twice the odds of reporting fair or poor quality of care (OR = 2.4 [95% CI: 1.4–4.3]). In addition, perceived discrimination in medical settings was significantly associated with report of not having enough time with the physician and not being as involved in decision-making as desired. These findings expand our understanding of perceived discriminatory experiences in health care and the consequences of it for patients, providers, and health care systems. This information is essential for identifying future provider interventions and improving the training of health care professionals.

Hispanic Parental Beliefs and Practices in the Management of Common Childhood Illnesses: A Review of the Literature

“…In one study, parents described feeling disrespected and ignored, leading to decreased confidence in their health care providers (Harrison & Scarinci, 2007). Other studies have reported similar findings with Hispanic individuals reporting higher degrees of discrimination and perceived poor quality of care than Caucasians (Abramson et al, 2015;Benjamins & Middleton, 2019).…”

Discrimination and Medical Mistrust in a Racially and Ethnically Diverse Sample of California Adults

“…These items had been selected from other instruments that have been used to measure perceived discrimination because of race/ethnicity, language, income, and lack or type of insurance. [25][26][27] Principal component analysis was used to identify potential factors underlying the 10-item instrument that measures the type of discrimination. Varimax rotation produced 2 distinct factors, explaining almost 60% of the variance.…”

COVID 19 related perceived discrimination in medical settings, March and April 2020

“…Fear of transmitting the disease can lead to discrimination in health care disparities. 12 This case is not limited to COVID-19. Previous studies on other transmittable diseases have also shown discrimination in health care services including:…”

“…Validity and reliability of the scale were high in previous studies. 12 , 15 Ten faculty members of Maragheh School of Medical Sciences were asked to comment on the scale, which led to removal of intelligence item and replacement of physical examination in the scale. Cronbach’s alpha was used to assess reliability of the scale in 20 patients (0.83).…”

“…Fear of transmitting the disease can lead to discrimination in medical care. 12 Fear of social isolation and stigma can increase prevalence of the disease in society because sick people might deny their symptoms and do not pursue treatment. Social stigma and discrimination not only have economic and social consequences, but also causes internalized fear and stigma in the patients.…”