Tekeste R, Grant M, Newton P, Davis N L, Tekeste M, Carter R
Mercy Medical Center, Baltimore, MD, USA.
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
J Racial Ethn Health Disparities. 2024 Sep 6. doi: 10.1007/s40615-024-02165-z.
Racial minorities report lower perceived quality of care received compared to non-Hispanic White Americans, resulting in racial disparities in patient satisfaction. Medical mistrust, defined as a lack of confidence in the medical establishment and the intentions of medical personnel, is more prevalent among racial minority groups and is associated with poorer health outcomes. This study examines the prevalence and racial differences of patient/caregiver medical mistrust and its relationship to patient satisfaction among the pediatric patient population at a large urban academic medical center. A cross-sectional anonymous survey was conducted for caregivers of pediatric families seen at an urban tertiary care facility, including demographic information, the Patient Satisfaction Questionnaire (PSQ), and the Group-Based Medical Mistrust Scale (GBMMS). Linear regressions and mediation analyses were performed, examining race-based medical mistrust and associations with patient satisfaction. Sixty-seven surveys (67% Black/African American, 24% White) were completed. Black/African American participants reported higher levels of medical mistrust (M = 2.29, SD = 0.88 vs. M = 1.37, SD = 0.50; p < .001), which was associated with lower patient satisfaction (p < .001). In a parallel mediation analysis, disaggregating the GBMMS into three subscales, a significant indirect relationship emerged between race and patient satisfaction via the subscale lack of support from healthcare providers (95% CI [- 1.52, - .02], p < .05). Black/African American participants were more likely to have medical mistrust, and greater medical mistrust was significantly associated with lower patient satisfaction. Black/African American participants were significantly more likely to perceive lower support from healthcare providers which, in turn, was associated with lower patient satisfaction. These findings identify potential areas for intervention to improve Black/African American patients' experience with healthcare.
与非西班牙裔美国白人相比，少数族裔报告称他们所接受的医疗服务质量较低，这导致了患者满意度方面的种族差异。医疗不信任被定义为对医疗机构和医务人员意图缺乏信心，在少数族裔群体中更为普遍，并且与较差的健康结果相关。本研究调查了一家大型城市学术医疗中心儿科患者群体中患者/照顾者医疗不信任的患病率和种族差异，以及它与患者满意度的关系。对在城市三级医疗设施就诊的儿科家庭的照顾者进行了一项横断面匿名调查，包括人口统计学信息、患者满意度问卷（PSQ）和基于群体的医疗不信任量表（GBMMS）。进行了线性回归和中介分析，研究基于种族的医疗不信任及其与患者满意度的关联。完成了67份调查问卷（67%为黑人/非裔美国人，24%为白人）。黑人/非裔美国参与者报告的医疗不信任水平更高（M = 2.29，SD = 0.88，而M = 1.37，SD = 0.50；p <.001），这与较低的患者满意度相关（p <.001）。在一项平行中介分析中，将GBMMS分解为三个子量表，通过医疗服务提供者缺乏支持这一子量表，种族与患者满意度之间出现了显著的间接关系（95% CI [-1.52, -.02]，p <.05）。黑人/非裔美国参与者更有可能存在医疗不信任，而更大程度的医疗不信任与更低的患者满意度显著相关。黑人/非裔美国参与者明显更有可能感觉到医疗服务提供者的支持较少，而这反过来又与较低的患者满意度相关。这些发现确定了潜在的干预领域，以改善黑人/非裔美国患者的医疗体验。
