Nativity status and patient perceptions of the patient-physician encounter: results from the Commonwealth Fund 2001 survey on disparities in quality of health care.

BACKGROUND

Although racial and ethnic differences in healthcare have been extensively documented in the United States, little attention has been paid to the quality of health care for the foreign-born population in the United States.

OBJECTIVES

This study examines the association between patient perceptions of the patient-physician interaction and nativity status.

RESEARCH DESIGN

Cross-sectional telephone survey.

SUBJECTS

A total of 6674 individuals (US-born = 5156; foreign-born = 1518) 18 years of age and older.

MEASURES

Seven questions measuring the quality of patient-physician interactions.

RESULTS

Of the 7 outcome variables examined in the unadjusted logistic regression model, only 2 remained statistically significant in the fully adjusted model. For both the total sample and for Asians only, compared with US-born, foreign-born individuals were at greater odds [total sample, odds ratio (OR) = 1.43; 95% confidence interval (CI) = 1.01-2.04; Asians, OR = 3.25; 95% CI = 1.18-8.95] of reporting that their physician did not involve them in their care as much as they would have liked. Compared with US-born Asians, foreign-born Asians were at greater odds of reporting that their physician did not spend as much time with them as they would have liked (OR = 4.19; 95% CI = 1.68-10.46).

DISCUSSION

Findings from our study suggest that we should not only track disparities by race and ethnicity but also by nativity status.