Quality of care and black American patients.

Even with major advancements in medical knowledge and significant improvements in health sciences technology, evidence still exists that blacks do not enjoy as full a measure of health as do other racial and ethnic groups. To attempt a better understanding of this situation, literature was reviewed to consider relationships between being black and issues related to quality of health care. It was determined that these relationships have not been studied to any great extent, either in quantity or quality. When such studies have been undertaken, they have been limited to mostly qualitative designs, and appropriate controls for confounding variables have been minimal. The psychiatric literature reports most of the studies with very few studies found in the literature of other specialties. A conceptual model is presented regarding race-related research. It is argued that a first step might be to study whether the quality of care differs when the physician and the patient are members of different racial groups compared with when the physician and patient are members of the same racial group. In all race-related research, it is necessary to carefully consider specific variables that may confound results, eg, diagnostic errors, age, sex, socioeconomic status, level of education, geographic locale, and method of payment for health-care services.