Montclair State University, Montclair, New Jersey.
University of West Georgia, Carrollton, Georgia.
Health Serv Res. 2019 Feb;54 Suppl 1(Suppl 1):234-242. doi: 10.1111/1475-6773.13089. Epub 2018 Dec 3.
To determine whether name and accent cues that the caller is Black shape physician offices' responses to telephone-based requests for well-child visits.
In this pilot study, we employed a quasi-experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind-coded into binary variables. Our case-control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions.
Compared to the control group, "Black" auditors were less likely to be told an office was accepting new patients and were more likely to experience both withholding behaviors and misattributions about public insurance. The strength of associations varied according to whether the cue was based on name or accent. Additionally, the likelihood and ways office personnel communicated that they were not accepting patients varied by region.
Linguistic profiling over the telephone is an aspect of structural racism that should be further studied and perhaps integrated into efforts to promote equitable access to care. Future research should look reactions to both name and accent, taking practice characteristics and regional differences into consideration.
确定来电者的姓名和口音提示是否会影响医生办公室对基于电话的儿童常规就诊预约请求的响应。
在这项初步研究中，我们采用了准实验性审计设计，并检查了儿科和家庭实践办公室的分层全国样本。我们的最终数据包括 205 次审计（410 次完成的电话）的信息。定性数据被盲法编码为二进制变量。我们使用 McNemar 检验进行的病例对照比较侧重于患者的接受程度、信息隐瞒、对话引导和错误归因。
与对照组相比，“黑人”审计员被告知该办公室正在接受新患者的可能性较小，并且更有可能经历信息隐瞒和对公共保险的错误归因。关联的强度根据提示是基于姓名还是口音而有所不同。此外，办公室人员表示不接受患者的可能性和方式因地区而异。
电话中的语言特征是结构性种族主义的一个方面，应进一步研究，并可能将其纳入促进公平获得医疗服务的努力中。未来的研究应该同时考虑姓名和口音，并考虑实践特征和地区差异。
