Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2008 Dec;23(12):2046-52. doi: 10.1007/s11606-008-0788-5. Epub 2008 Oct 2.

Impact of patient race on patient experiences of access and communication in HIV care.

Author information

1
Department of Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA. korthuis@ohsu.edu

Abstract

BACKGROUND:

Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes.

OBJECTIVE:

To explore associations between race and HIV-infected patients' experiences of access and communication.

DESIGN:

This was a cross-sectional survey.

PARTICIPANTS:

Nine hundred and fifteen HIV-infected adults receiving care at 14 U.S. HIV clinics.

MEASUREMENTS:

Dependent variables included patients' reports of travel time to their HIV care site and waiting time to see their HIV provider (access) and ratings of their HIV providers on always listening, explaining, showing respect, and spending enough time with them (communication). We used multivariate logistic regression to estimate associations between patient race and dependent variables, and random effects models to estimate site-level contributions.

RESULTS:

Patients traveled a median 30 minutes (range 1-180) and waited a median 20 minutes (range 0-210) to see their provider. On average, blacks and Hispanics reported longer travel and wait times compared with whites. Adjusting for HIV care site attenuated this association. HIV care sites that provide services to a greater proportion of blacks and Hispanics may be more difficult to access for all patients. The majority of patients rated provider communication favorably. Compared to whites, blacks reported more positive experiences with provider communication.

CONCLUSIONS:

We observed racial disparities in patients' experience of access to care but not in patient-provider communication. Disparities were explained by poor access at minority-serving clinics. Efforts to make care more patient-centered for minority HIV-infected patients should focus more on improving access to HIV care in minority communities than on improving cross-cultural patient-provider interactions.

PMID:
18830770
PMCID:
PMC2596522
DOI:
10.1007/s11606-008-0788-5
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Support Center