The association between Asian patient race/ethnicity and lower satisfaction scores
Abstract Background Patient satisfaction is increasingly being used to assess, and financially reward, provider performance. Previous studies suggest that race/ethnicity (R/E) may impact satisfaction, yet few practices adjust for patient R/E. The objective of this study is to examine R/E differences...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-07-01
|
Series: | BMC Health Services Research |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12913-020-05534-6 |
id |
doaj-d424b60399344ba5ac92f9cd2aeccd2f |
---|---|
record_format |
Article |
spelling |
doaj-d424b60399344ba5ac92f9cd2aeccd2f2020-11-25T03:25:33ZengBMCBMC Health Services Research1472-69632020-07-0120111110.1186/s12913-020-05534-6The association between Asian patient race/ethnicity and lower satisfaction scoresLillian Liao0Sukyung Chung1Jonathan Altamirano2Luis Garcia3Magali Fassiotto4Bonnie Maldonado5Paul Heidenreich6Latha Palaniappan7Department of Health Research and Policy, Stanford University School of MedicinePalo Alto Medical Foundation Research InstituteOffice of Faculty Development and Diversity, Stanford University School of MedicineOffice of Faculty Development and Diversity, Stanford University School of MedicineOffice of Faculty Development and Diversity, Stanford University School of MedicineOffice of Faculty Development and Diversity, Stanford University School of MedicineDepartment of Medicine, Stanford University School of MedicineDepartment of Medicine, Stanford University School of MedicineAbstract Background Patient satisfaction is increasingly being used to assess, and financially reward, provider performance. Previous studies suggest that race/ethnicity (R/E) may impact satisfaction, yet few practices adjust for patient R/E. The objective of this study is to examine R/E differences in patient satisfaction ratings and how these differences impact provider rankings. Methods Patient satisfaction survey data linked to electronic health records from two large outpatient centers in northern California – a non-profit organization of community-based clinics (Site A) and an academic medical center (Site B) – was collected and analyzed. Participants consisted of adult patients who received outpatient care at Site A from December 2010 to November 2014 and Site B from March 2013 to August 2014, and completed Press-Ganey Medical Practice Survey questionnaires (N = 216,392 (Site A) and 30,690 (Site B)). Self-reported non-Hispanic white (NHW), Black, Latino, and Asian patients were studied. For six questions each representing a survey subdomain, favorable ratings were defined as top-box (“very good”) compared to all other categories (“very poor,” “poor,” “fair,” and “good”). Using multivariable logistic regression with provider random effects, we assessed whether the likelihood of giving favorable ratings differed by patient R/E, adjusting for patient age and sex. Results Asian, younger and female patients provided less favorable ratings than other R/E, older and male patients. After adjustment, Asian patients were less likely than NHW patients to provide top-box ratings to the overall assessment question “likelihood of recommending this practice to others” (Site A: Asian predicted probability (PP) 0.680, 95% confidence interval (CI): 0.675–0.685 compared to NHW PP 0.820, 95% CI: 0.818–0.822; Site B: Asian PP 0.734, 95% CI: 0.733–0.736 compared to NHW PP 0.859, 95% CI: 0.859–0.859). The effect sizes for Asian R/E were greater than the effect sizes for older age and female sex. An absolute 3% decrease in mean composite score between providers serving different percentages of Asian patients translated to an absolute 40% drop in national ranking. Conclusions Patient satisfaction scores may need to be adjusted for patient R/E, particularly for providers caring for high panel percentages of Asian patients.http://link.springer.com/article/10.1186/s12913-020-05534-6Patient satisfactionRace/ethnicityCultural differences |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lillian Liao Sukyung Chung Jonathan Altamirano Luis Garcia Magali Fassiotto Bonnie Maldonado Paul Heidenreich Latha Palaniappan |
spellingShingle |
Lillian Liao Sukyung Chung Jonathan Altamirano Luis Garcia Magali Fassiotto Bonnie Maldonado Paul Heidenreich Latha Palaniappan The association between Asian patient race/ethnicity and lower satisfaction scores BMC Health Services Research Patient satisfaction Race/ethnicity Cultural differences |
author_facet |
Lillian Liao Sukyung Chung Jonathan Altamirano Luis Garcia Magali Fassiotto Bonnie Maldonado Paul Heidenreich Latha Palaniappan |
author_sort |
Lillian Liao |
title |
The association between Asian patient race/ethnicity and lower satisfaction scores |
title_short |
The association between Asian patient race/ethnicity and lower satisfaction scores |
title_full |
The association between Asian patient race/ethnicity and lower satisfaction scores |
title_fullStr |
The association between Asian patient race/ethnicity and lower satisfaction scores |
title_full_unstemmed |
The association between Asian patient race/ethnicity and lower satisfaction scores |
title_sort |
association between asian patient race/ethnicity and lower satisfaction scores |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2020-07-01 |
description |
Abstract Background Patient satisfaction is increasingly being used to assess, and financially reward, provider performance. Previous studies suggest that race/ethnicity (R/E) may impact satisfaction, yet few practices adjust for patient R/E. The objective of this study is to examine R/E differences in patient satisfaction ratings and how these differences impact provider rankings. Methods Patient satisfaction survey data linked to electronic health records from two large outpatient centers in northern California – a non-profit organization of community-based clinics (Site A) and an academic medical center (Site B) – was collected and analyzed. Participants consisted of adult patients who received outpatient care at Site A from December 2010 to November 2014 and Site B from March 2013 to August 2014, and completed Press-Ganey Medical Practice Survey questionnaires (N = 216,392 (Site A) and 30,690 (Site B)). Self-reported non-Hispanic white (NHW), Black, Latino, and Asian patients were studied. For six questions each representing a survey subdomain, favorable ratings were defined as top-box (“very good”) compared to all other categories (“very poor,” “poor,” “fair,” and “good”). Using multivariable logistic regression with provider random effects, we assessed whether the likelihood of giving favorable ratings differed by patient R/E, adjusting for patient age and sex. Results Asian, younger and female patients provided less favorable ratings than other R/E, older and male patients. After adjustment, Asian patients were less likely than NHW patients to provide top-box ratings to the overall assessment question “likelihood of recommending this practice to others” (Site A: Asian predicted probability (PP) 0.680, 95% confidence interval (CI): 0.675–0.685 compared to NHW PP 0.820, 95% CI: 0.818–0.822; Site B: Asian PP 0.734, 95% CI: 0.733–0.736 compared to NHW PP 0.859, 95% CI: 0.859–0.859). The effect sizes for Asian R/E were greater than the effect sizes for older age and female sex. An absolute 3% decrease in mean composite score between providers serving different percentages of Asian patients translated to an absolute 40% drop in national ranking. Conclusions Patient satisfaction scores may need to be adjusted for patient R/E, particularly for providers caring for high panel percentages of Asian patients. |
topic |
Patient satisfaction Race/ethnicity Cultural differences |
url |
http://link.springer.com/article/10.1186/s12913-020-05534-6 |
work_keys_str_mv |
AT lillianliao theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT sukyungchung theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT jonathanaltamirano theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT luisgarcia theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT magalifassiotto theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT bonniemaldonado theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT paulheidenreich theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT lathapalaniappan theassociationbetweenasianpatientraceethnicityandlowersatisfactionscores AT lillianliao associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT sukyungchung associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT jonathanaltamirano associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT luisgarcia associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT magalifassiotto associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT bonniemaldonado associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT paulheidenreich associationbetweenasianpatientraceethnicityandlowersatisfactionscores AT lathapalaniappan associationbetweenasianpatientraceethnicityandlowersatisfactionscores |
_version_ |
1724596438597369856 |