Perceived discrimination and reported delay of pharmacy prescriptions and medical tests

Houtven, Courtney Harold Van; Voils, Corrine I.; Oddone, Eugene Z.; Weinfurt, Kevin P.; Friedman, Joëlle Y.; Schulman, Kevin A.; Bosworth, Hayden B.

doi:10.1007/s11606-005-0104-6

Cited by 141 publications

(110 citation statements)

References 47 publications

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“…Indeed, previous studies have linked perceived discrimination to lower patientreported adherence 42 and delays in filling prescriptions. 43 While we found no evidence in this diabetes population that perceived discrimination indicated inferior quality, it does not eliminate the important responsibility of healthcare systems to continue monitoring and ensuring uniform care across members.…”

Section: Discussioncontrasting

confidence: 58%

Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

et al. 2011

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BACKGROUND: Racial/ethnic minority patients are more likely to report experiences with discrimination in the healthcare setting, potentially leading to reduced access to appropriate care; however, few studies evaluate reports of discrimination with objectively measured quality of care indicators. OBJECTIVE: To evaluate whether patient-reported racial/ethnic discrimination by healthcare providers was associated with evidence of poorer quality care measured by medication intensification. RESEARCH DESIGN AND PARTICIPANTS: Baseline data from the Diabetes Study of Northern California (DISTANCE), a random, race-stratified sample from the Kaiser Permanente Diabetes Registry from 2005-2006, including both survey and medical record data. MAIN MEASURES: Self-reported healthcare provider discrimination (from survey data) and medication intensification (from electronic prescription records) for poorly controlled diabetes patients (A1c≥9.0%; systolic BP≥140 mmHg or diastolic BP≥90 mmHg; low-density lipoprotein (LDL)≥130 mg/dl). KEY RESULTS: Of 10,409 eligible patients, 21% had hyperglycemia, 14% had hyperlipidemia, and 32% had hypertension. Of those with hyperglycemia, 59% had their medications intensified, along with 40% with hyperlipidemia, 33% with hypertension, and 47% in poor control of any risk factor. In adjusted log-binomial GEE models, discrimination was not associated with medication intensification [RR=0.96 (95% CI: 0.74, 1.24) for hyperglycemia, RR=1.23 (95% CI: 0.93, 1.63) for hyperlipidemia, RR=1.06 (95% CI: 0.69, 1.61) for hypertension, and RR=1.08 (95% CI: 0.88, 1.33) for the composite cohort]. CONCLUSIONS: We found no evidence that patientreported healthcare discrimination was associated with less medication intensification. While not associated with this technical aspect of care, discrimination could still be associated with other aspects of care (e.g., patientcenteredness, communication).

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Section: Discussioncontrasting

confidence: 58%

Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

et al. 2011

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“…Patients who report racial/ethnic discrimination are more likely to postpone medical tests and treatment, 27 underutilize health services, 28 and forego preventive health services. [29][30][31] They have lower satisfaction with care, 32,33 higher levels of medical mistrust, 32 and are less likely to adhere to physicians' recommendations.…”

Section: Perceived Discrimination In Health Carementioning

confidence: 99%

Dimensions of Racial Identity and Perceived Discrimination in Health Care

Štěpáníková

Oates

2016

Ethn Dis

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Objective: Perceived discrimination is an important risk factor for minority health. Drawing from the scholarship on multidimensionality of race, this study examines the relationships between perceived discrimination in health care and two dimensions of racial identity: self-identified race/ethnicity and perceived attributed race/ ethnicity (respondents’ perceptions of how they are racially classified by others).Methods: We used Behavioral Risk Factor Surveillance System data collected in 2004- 2013 and we specifically examined the data on perceived racial discrimination in health care during the past 12 months, perceived attributed race/ethnicity, and self-identified race/ethnicity.Results: In models adjusting for sociodemographic and other factors, both dimensions of racial/ethnic identity contributed independently to perceived discrimination in health care. After controlling for self-identified race/ethnicity, respondents who reported being classified as Black, Asian, Hispanic, and Native American had higher likelihood of perceived discrimination than respondents who reported being classified as White. Similarly, after taking perceived attributed race/ethnicity into account, self-identified Blacks, Native Americans, and multiracial respondents were more likely to report perceived discrimination than counterparts who self-identified as White. The model using only perceived attributed race/ ethnicity to predict perceived discrimination showed a superior fit with the data than the model using only self-identified race/ ethnicity.Conclusion: Perceived attributed race/ ethnicity captures an aspect of racial/ethnic identity that is correlated, but not interchangeable, with self-identified race/ethnicity and contributes uniquely to perceived discrimination in health care. Applying the concept of multidimensionality of race/ ethnicity to health disparities research may reveal understudied mechanisms linking race/ethnicity to health risks.Ethn Dis. 2016;26(4):501-512; doi:10.18865/ ed.26.4.501

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“…Although prior studies have demonstrated that perceived discrimination is associated with delays in seeking necessary medical care, [4][5][6] delays in obtaining prescriptions, treatments, or tests, 4,7 and substituting alternative medicine for conventional care, 8 evidence regarding the relationship between discrimination and use of preventive health services such as vaccinations or recommended screenings has been mixed. 6,9,10 Therefore, the purpose of the current study was to examine the association between perceived discrimination in health care and utilization of preventive health services.…”

Section: Introductionmentioning

confidence: 99%

Perceived Discrimination in Health Care and Use of Preventive Health Services

et al. 2008

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OBJECTIVE: To examine the relationship between perceived discrimination and preventive health care utilization. DESIGN AND PARTICIPANTS:Cross-sectional analysis using the 2004 Behavioral Risk Factor Surveillance System "Reactions to Race" module (N = 28,839). MEASUREMENTS:Outcomes were self-reported utilization of seven preventive health services. Predictors included perceived negative and positive racial discrimination (vs. none) while seeking health care in the past year. Multivariable models adjusted for additional patient characteristics. MAIN RESULTS:In unadjusted models, negative discrimination was significantly associated with less utilization of mammogram, pap test, PSA test, blood stool test, and sigmoidoscopy/colonoscopy (ORs = 0.53-0.73, p < .05), but not flu or pneumococcal vaccines (ORs = 0.76 and 0.84). Positive discrimination was significantly associated with more utilization of all services (ORs = 1.29-1.58, p < .05) except pap test (OR = 0.94). In adjusted models, neither negative nor positive discrimination was predictive of utilization, except for PSA test (positive discrimination OR = 1.33, p < .05).CONCLUSIONS: Perceived racial discrimination in health care does not independently predict preventive health care utilization.KEY WORDS: perceived discrimination; preventive health; behavioral risk factor surveillance system; centers for disease control and prevention.

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Perceived discrimination and reported delay of pharmacy prescriptions and medical tests

Abstract: A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays.

Cited by 141 publications

References 47 publications

Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

Dimensions of Racial Identity and Perceived Discrimination in Health Care

Perceived Discrimination in Health Care and Use of Preventive Health Services

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