Johannes Bobbie L, Mainous Arch G, Prochnow Tyler, Chen Xuewei, Ortiz Selena E, Smith Matthew Lee
Department of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA.
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA.
J Patient Exp. 2025 May 20;12:23743735251341732. doi: 10.1177/23743735251341732. eCollection 2025.
The role that racial and ethnic concordance between rural patients and their providers may play in improving health-related behaviors and access to care may be associated with a lack of trust. Therefore, our study identifies the patient characteristics associated with: (1) perceived importance of having racial and ethnic concordance; and (2) not having a routine provider visit in the past year among rural patients living throughout the United States. Data were collected through an online survey using Qualtrics, incorporating validated questionnaire items to assess health beliefs, healthcare practices, access to care, and patient-provider distrust. Sample ( = 166) characteristics were compared using bivariate analyses. Two binary logistic regression models with backward entry were fitted to assess variables associated with perceived importance of concordance and a routine visit in the past year, controlling for distrust in providers, healthcare access, health literacy, and demographics. High distrust in providers was associated with perceived importance of racial and ethnic concordance with one's provider (OR = 9.18) and not having a routine visit (OR = 3.35). This study highlights the complex interplay between racial and ethnic concordance, distrust in providers, and healthcare utilization among rural populations, emphasizing the need for multifaceted approaches to improve healthcare access and outcomes. Future studies should determine whether perceived importance of concordance mediates the relationship between distrust in providers and getting an annual routine visit.
农村患者与其医疗服务提供者之间的种族和民族一致性在改善与健康相关行为及获得医疗服务方面可能发挥的作用，可能与缺乏信任有关。因此，我们的研究确定了与以下方面相关的患者特征：（1）种族和民族一致性的感知重要性；（2）在过去一年中，美国各地农村患者未进行常规医疗服务提供者就诊的情况。数据通过使用Qualtrics的在线调查收集，纳入了经过验证的问卷项目，以评估健康信念、医疗保健实践、获得医疗服务的机会以及患者与医疗服务提供者之间的不信任。使用双变量分析比较样本（n = 166）特征。拟合了两个采用向后进入法的二元逻辑回归模型，以评估与一致性的感知重要性和过去一年的常规就诊相关的变量，同时控制对医疗服务提供者的不信任、医疗服务可及性、健康素养和人口统计学因素。对医疗服务提供者的高度不信任与认为种族和民族与自己的医疗服务提供者一致的重要性（OR = 9.18）以及未进行常规就诊（OR = 3.35）相关。本研究强调了农村人口中种族和民族一致性、对医疗服务提供者的不信任以及医疗保健利用之间的复杂相互作用，强调需要采取多方面方法来改善医疗服务可及性和结果。未来的研究应确定一致性的感知重要性是否介导了对医疗服务提供者的不信任与进行年度常规就诊之间的关系。
