Type of Document Dissertation Author Slade, Catherine Putnam Author's Email Address cslade1@student.gsu.edu URN etd-07092008-150900 Title Does Patient-Centered Care Affect Racial Disparities in Health? Degree Ph.D. Department Public Administration and Urban Studies Advisory Committee
Advisor Name Title Dr. Robert J. Eger, III Committee Chair Dr. Christopher M. Weible Committee Member Dr. Gregory B. Lewis Committee Member Dr. Monica M. Gaughan Committee Member Dr. Valerie A. Hepburn Committee Member Keywords
- discrimination in medical care
- allied health personnel and patient
- health policy
- pay-for-performance
- health care delivery
- race interaction terms
Date of Defense 2007-11-30 Availability unrestricted Abstract This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.Files
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