title: Patient attitudes regarding healthcare utilization and referral: a descriptive comparison in African- and Caucasian Americans with chronic pain.
abstract: The purpose of this study was to evaluate healthcare utilization and referral patterns for pain management services in a racially and ethnically diverse population. A study-specific mail survey was directed at African- (N=324) and Caucasian Americans (N=300) receiving chronic pain treatment at a tertiary care pain center to address their healthcare access, referral, and utilization patterns. Overall, 46% (N=286) responded, with the majority of respondents being Caucasian Americans (57%) and women (68%). The majority (58%) reported asking their physicians to refer them to a pain physician. African Americans were more likely to report that chronic pain was a major reason for financial problems. They made significantly more visits to the emergency room for pain care. African Americans agreed more that ethnicity and culture affected access to healthcare and pain management. They also tended to agree more than Caucasian Americans that pain medication could not control pain. These results demonstrate significant differences in healthcare utilization, access, and attitudes amongst African- and Caucasian Americans receiving chronic pain management. In light of the socioeconomic and health consequences of chronic pain, these results suggest the need for further studies addressing variability in pain care access and utilization in diverse populations.
authors.affiliation: Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109-0048, USA. carmeng@umich.edu
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Green
authors.forename: Tamara A
authors.initials: TA
authors.lastname: Baker
authors.forename: S Khady
authors.initials: SK
authors.lastname: Ndao-Brumblay
mesh_terms: D001741:Black or African American / Q000523:psychology*; D002908:Chronic Disease; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010146:Pain / Q000208:ethnology*; D059408:Pain Management; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011446:Prospective Studies; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D044465:White People / Q000523:psychology*