Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California.
Palo Alto Medical Foundation Research Institute, Palo Alto, California.
JAMA Netw Open. 2019 Feb 1;2(2):e190027. doi: 10.1001/jamanetworkopen.2019.0027.
Patient satisfaction scores are used to inform decisions about physician compensation, and there remains a lack of consensus regarding the need to adjust scores for patient race/ethnicity. Previous research suggests that patients prefer physicians of the same race/ethnicity as themselves and that Asian patients provide lower satisfaction scores than non-Hispanic white patients.
To examine whether Asian physicians receive less favorable patient satisfaction scores relative to non-Hispanic white physicians.
DESIGN, SETTING, AND PARTICIPANTS: This population-based survey study used data from Press Ganey Outpatient Medical Practice Surveys collected from December 1, 2010, to November 30, 2014, which included 149 775 patient survey responses for 962 physicians. Every month, 5 patients per physician were randomly selected to complete a satisfaction survey after an outpatient visit. Hierarchical multivariable logistic regression was used to examine the association between Asian race/ethnicity of the physician and racial/ethnic concordance of the patient with the probability of receiving the highest score on the survey item rating the likelihood to recommend the physician. Statistical analysis was performed from April 2 to August 27, 2018.
Physician characteristics included race/ethnicity, sex, years in practice, and proportion of Asian patient responders. Patient characteristics included race/ethnicity, sex, age, and language spoken.
The highest score (a score of 5 on a 1-5 Likert scale, where 1 indicates very poor and 5 indicates very good) on the survey item rating the likelihood to recommend the physician on the Press Ganey Outpatient Medical Practice Survey.
Of the 962 physicians in this study, 515 (53.5%) were women; physicians had a mean (SD) of 19.9 (9.1) years of experience since graduating medical school; 573 (59.6%) were white, and 350 (36.4%) were Asian. In unadjusted analyses, the odds of receiving the highest score on the survey item rating the likelihood to recommend the physician were lower for Asian physicians compared with non-Hispanic white physicians (odds ratio, 0.78; 95% CI, 0.72-0.84; P < .001). This association was not significant after adjusting for patient characteristics, including patient race/ethnicity. However, Asian patients were less likely to give the highest scores relative to non-Hispanic white patients (odds ratio, 0.56; 95% CI, 0.54-0.58; P < .001), regardless of physician race/ethnicity.
This study suggests that Asian physicians may be more likely to receive lower patient satisfaction scores because they serve a greater proportion of Asian patients. Patient satisfaction scores should be adjusted for patient race/ethnicity.
患者满意度评分用于为医师薪酬决策提供信息，但对于是否需要根据患者的种族/民族调整评分，仍缺乏共识。先前的研究表明，患者更喜欢与自己种族/民族相同的医师，而亚洲患者的满意度评分低于非西班牙裔白人患者。
检查亚裔医师相对于非西班牙裔白人医师是否获得较低的患者满意度评分。
设计、地点和参与者：本基于人群的调查研究使用了 2010 年 12 月 1 日至 2014 年 11 月 30 日期间从 Press Ganey 门诊医疗实践调查中收集的数据，其中包括 962 名医师的 149775 名患者调查回复。每月，每位医师随机选择 5 名患者，在门诊就诊后完成满意度调查。采用分层多变量逻辑回归检查医师的亚裔种族/民族与患者的种族/民族一致性与调查项目中评分最高（即对推荐医师可能性的评分，1 表示非常差，5 表示非常好）的概率之间的关联。统计分析于 2018 年 4 月 2 日至 8 月 27 日进行。
医师特征包括种族/民族、性别、从业年限和亚裔患者应答者比例。患者特征包括种族/民族、性别、年龄和语言。
Press Ganey 门诊医疗实践调查中对推荐医师可能性的评分最高（即对推荐医师可能性的评分，1 表示非常差，5 表示非常好）。
在这项研究中的 962 名医师中，515 名（53.5%）为女性；医师平均（SD）有 19.9（9.1）年的从医学院毕业以来的经验；573 名（59.6%）为白人，350 名（36.4%）为亚裔。在未调整的分析中，与非西班牙裔白人医师相比，亚裔医师获得调查项目中评分最高的可能性较低（优势比，0.78；95%CI，0.72-0.84；P < .001）。在调整患者特征（包括患者种族/民族）后，这种关联并不显著。然而，亚裔患者的评分低于非西班牙裔白人患者（优势比，0.56；95%CI，0.54-0.58；P < .001），无论医师的种族/民族如何。
本研究表明，亚裔医师可能更有可能获得较低的患者满意度评分，因为他们服务的亚裔患者比例更大。患者满意度评分应根据患者的种族/民族进行调整。
