Race and preventive services delivery among black patients and white patients seen in primary care.
BACKGROUND
Numerous studies have documented racial disparities in delivery of health care treatment services, but there is little information to determine whether similar disparities exist in the delivery of preventive services.


OBJECTIVE
To determine if disparities exist in preventive service delivery to non-Hispanic white patients and black patients in primary care.


METHODS
Multimethod study using direct observation of patient encounters, medical record review, and patient exit questionnaire.


METHODS
Four thousand three hundred thirteen outpatients presenting to 138 family physicians.


METHODS
Delivery of 15 screening, 24 health-habit counseling and 11 immunization services recommended by the US Preventive Services Task Force.


RESULTS
Using multilevel linear regression analysis, no significant racial differences were found in rates of delivery of screening services or immunizations. However, black patients were more likely to receive preventive health-habit counseling (mean percent of patients up-to-date on all recommended counseling services, adjusted for covariates: 11.6% for black patients, 9.5% for whites, P = 0.003).


CONCLUSIONS
Black patients able to access primary care receive preventive services at rates equal to or greater than white patients. This suggests that efforts to increase delivery of preventive care in black patients need to focus on access to primary care.
Williams
R L
RL
Department of Family and Medicine, University of New Mexico, Albuquerque 87131, USA. rlwilliams@salud.unm.edu
Flocke
S A
SA
Stange
K C
KC
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009820:Ohio; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D044465:White People / Q000706:statistics & numerical data*