Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA.
School of Social Work, Texas State University, San Marcos, TX, USA.
Ethn Health. 2021 Apr;26(3):448-459. doi: 10.1080/13557858.2018.1514457. Epub 2018 Aug 25.
The present study examined factors associated with the preference for patient-provider ethnic concordance in Asian Americans. With data drawn from the 2015 Asian American Quality of Life Survey ( = 2535), a logistic regression model of the preference for patient-provider ethnic concordance was tested with demographic (age, gender, ethnicity, marital status, education), health and access (chronic medical conditions, self-rated health, health insurance coverage), immigration-related (place of birth, length of stay in the US, English proficiency, acculturation), and adverse experience (perceived discrimination, communication problems in healthcare settings) variables. Over half (52.4%) of those in the sample preferred to be treated by a healthcare provider from their own ethnic background. In a multivariate model, the odds for preferring ethnic concordance were 1.52-1.64 times higher among individuals in earlier stages of immigration, language acquisition, and acculturation. Individuals who had experienced communication problems in healthcare settings presented 3.74 times higher odds for preferring ethnic concordance than did counterparts without such experience. The results emphasized the value of paying attention to patient-provider concordance when treating Asian Americans either relatively new to the country or who have had previous problems communicating with health professionals. The findings also provide implications for improving workforce diversity in healthcare delivery and medical education.
本研究考察了与亚洲美籍人群选择与自身族裔相符的医患关系偏好相关的因素。本研究利用 2015 年亚裔美国人生活质量调查( = 2535)的数据,通过逻辑回归模型对与人口统计学(年龄、性别、族裔、婚姻状况、教育)、健康和获取途径(慢性疾病、自我报告的健康状况、健康保险覆盖范围)、移民相关因素(出生地、在美国的居住时间、英语熟练程度、文化适应)以及不良经历(感知歧视、医疗保健环境中的沟通问题)变量进行分析,探讨了对医患族裔相符的偏好。在样本中,超过一半(52.4%)的人更愿意接受与自己族裔背景相符的医疗服务提供者的治疗。在多变量模型中,处于移民、语言习得和文化适应早期阶段的个体选择族裔相符的可能性是其他个体的 1.52-1.64 倍。与没有此类经历的个体相比,在医疗保健环境中遇到沟通问题的个体选择族裔相符的可能性高 3.74 倍。研究结果强调了在治疗刚到美国或与医疗专业人员沟通存在问题的亚裔美国人时,关注医患相符性的重要性。研究结果还为改善医疗服务和医学教育领域的劳动力多样性提供了启示。