title: Equity, effectiveness, and efficiency in health care for immigrants and minorities: the essential triad for improving health outcomes.
abstract: This paper critically examines criteria for equitable, effective, and efficient health care and explores theoretical propositions about how these three components of health care affect health outcomes and patient satisfaction. Findings from four studies with older, low-income immigrants and minorities, including Chinese and Russian immigrants, U.S.-born African Americans, and a non-immigrant, non-minority comparison group of Caucasians are presented. Critical analyses suggest that (a) equity, effectiveness, and efficiency must operate as a triad to improve health outcomes, and (b) patient satisfaction is not necessarily related to effectiveness and efficiency. This article is an adapted version of a keynote address at the 12th Annual Primary Care for the Underserved Conference held May 2004 in Fort Lauderdale, FL.
authors.affiliation: Wayne State University, 5557 Cass Avenue, Detroit, MI 48202, USA. aroian@wayne.edu
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Aroian
mesh_terms: D001741:Black or African American / Q000523:psychology; D001213:Asian / Q000523:psychology; D001294:Attitude to Health / Q000208:ethnology; D002681:China / Q000208:ethnology; D003152:Community Health Nursing / Q000592:standards*; D003466:Cultural Characteristics; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards*; D006302:Health Services Research; D006801:Humans; D008913:Minority Groups / Q000523:psychology; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards; D017060:Patient Satisfaction / Q000208:ethnology; D011320:Primary Health Care / Q000592:standards*; D012426:Russia / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology