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

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.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Korthuis PT,Saha S,Fleishman JA,McGrath MM,Josephs JS,Moore RD,Gebo KA,Hellinger J,Beach MC,HIV Research Network.

doi

10.1007/s11606-008-0788-5

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

2046-52

issue

eissn

0884-8734

issn

1525-1497

journal_volume

pub_type

杂志文章,多中心研究

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