Assessing quality of care for African Americans with hypertension.
African Americans bear a disproportionate burden of hypertension. A causal-modeling design, using Donabedian's Quality Framework, tested hypothesized relationships among structure, process, and outcome variables to assess quality of care provided to this population. Structural assessment revealed that administrative and staff organization affected patients' trust in their provider and satisfaction with their care. Interpersonal process factors of racism, cultural mistrust, and trust in providers had a significant effect on satisfaction, and perceived racism had a negative effect on blood pressure (BP). Poorer quality in technical processes of care was associated with higher BP. Findings support the utility of Donabedian's framework for assessing quality of care in a disease-specific population.
Peters
Rosalind M
RM
Wayne State University College of Nursing, Detroit, MI, USA. rpeters@wayne.edu
Benkert
Ramona
R
Dinardo
Ellen
E
Templin
Thomas
T
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction / Q000208:ethnology*; D011787:Quality of Health Care; D035502:Trust / Q000523:psychology; D014481:United States