Aims Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patent-centeredness, and dissatisfaction with care in adults with type 2 diabetes. Methods 602 patients from two primary care clinics in Charleston SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care. The models control for race, site, age, gender, marital status, duration of diabetes, education, hours worked weekly, income, and health status. Results The mean age was 61.5 years, with 66.3% non-Hispanic blacks, and 41.9% earning less than $20,000 annually. In final adjusted analyses, lower patient-centered care was associated with a higher discrimination score (β=−0.28; p=0.006), reporting at least 1 category of discrimination (β=−1.47; p=0.002), and reporting at least 2 categories of discrimination (β=−1.34; p=0.004). Dissatisfaction with care was associated with at least 2 categories of discrimination (β=0.45; p=0.002). No significant associations were seen with quality of care indicators. Conclusions Increased cumulative discrimination was associated with decreased feeling of patient-centeredness and increased dissatisfaction with care. However, these perceptions of discrimination were not significantly associated with quality indicators.

sis of these data also identified a subset of genes that distinguish tumor specimens from each other as well as from normal prostate tissue. Random permutation of the sample labels clearly indicates that the subset of genes separating tumor subgroups far exceeds that expected by chance alone (P=0.002). This work indicates that investigation of prostate cancer based on gene expression can identify genes that may help distinguish more aggressive forms of this disease.