Race, gender, and language concordance in the primary care setting

Abstract

Purpose

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care.

Design/methodology/approach

The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported.

Findings

Adjusting for covariates, the following items remained statistically significant: race – choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender – choosing primary care physician as USC and USC having office hours; and language – lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted.

Research limitations/implications

While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross‐sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups.

Practical implications

This study indicates that more research is needed in this area to determine future resource allocation and policy direction.

Originality/value

The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

Citation

Martin, B.C., Shi, L. and Ward, R.D. (2009), "Race, gender, and language concordance in the primary care setting", International Journal of Health Care Quality Assurance, Vol. 22 No. 4, pp. 340-352. https://doi.org/10.1108/09526860910964816