How patients deal with disparities in patient medical care

Aug 16 2005

A new pilot study out of the University of Cincinnati takes a new look at how patients deal with disparities in patient medical care – disparities that have been documented in hundreds of studies in the past.

This poll of approximately 1,000 people in Greater Cincinnati found that the more disadvantaged the patient felt in terms of race, gender or socioeconomic background, the more likely he or she worked on presenting a positive self image while seeking medical care.

Researchers Jennifer Malat, an assistant professor of sociology at the University of Cincinnati, and Michelle van Ryn of the Department of Family Medicine and Community Health and Division of Epidemiology at the University of Minnesota, analyzed their data based on questions they presented to approximately 1,000 people through a Greater Cincinnati Survey.

Malat says previous research aimed at eliminating disparities in medical care took an approach that assumed the beliefs and attitudes of disadvantaged patients were at odds with the health care system, and failed to consider whether patients tried to take action to get quality medical care or alleviate negative perceptions of health care providers. So to explore that direction, the researchers asked questions such as:

• Do you think it's important to let your doctor know you are intelligent?
• Do you think it's important to let your doctor know you care about your health?
• Do you feel it's important to dress nicely when you visit the doctor's office?
• Do you feel it's important to be on time for your appointment?
• Do you feel it's important to be friendly with your health care provider?

"On every variable, the people who were more disadvantaged were more likely to say yes – women were more likely to say yes to those questions than men, African Americans were more likely to answer yes than whites, people of lower income were more likely to answer yes than those from wealthy backgrounds," Malat says. "Based on these findings, we suggest several routes for future research that will advance our understanding of patients' everyday strategies for getting the best health care," Malat says.