The medical dialogue: disentangling differences between Hispanic and non-Hispanic whites.
BACKGROUND
Patients' race and ethnicity play an important role in quality of and access to healthcare in the United States.


OBJECTIVE
To examine the influence of ethnicity--Hispanic whites vs. non-Hispanic whites--on respondents' self-reported interactions with healthcare providers. To understand, among Hispanic whites, how demographic and socioeconomic characteristics impact their interactions with healthcare providers.


METHODS
Cross-sectional analysis of the 2002 Medical Expenditure Panel Survey, a nationally representative survey on medical care conducted by the Agency for Healthcare Research and Quality.


METHODS
Civilian, noninstitutionalized U.S. population aged > or = 18 years who reported visiting a healthcare provider within the past 12 months prior to data collection.


RESULTS
After controlling for several demographic and socioeconomic covariates, compared to non-Hispanic whites (reference group), Hispanic whites who had visited a doctor's office or clinic in the past 12 months were more likely to report that their healthcare provider "always" listened to them [odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.21-1.53], explained things so that they understood (OR = 1.25, 95% CI 1.10-1.41), showed respect for what they had to say (OR = 1.52, 95% CI 1.35-1.72), and spent enough time with them (OR = 1.22, 95% CI 1.08-1.38). However, Hispanics were less likely to indicate that their health care provider "always" gave them control over treatment options (OR = 0.83, 95% CI 0.72-0.95) as compared to non-Hispanics. Within the Hispanic population exclusively, age, place of residence, census region, health insurance status, and presence of a usual source of care influenced self-reported interactions with healthcare providers.


CONCLUSIONS
Hispanic white respondents were more likely to report that some aspects of provider-patient interactions were indicative of high quality, whereas those related to decision-making autonomy were not. These somewhat paradoxical results should be examined more fully in future research.
Wallace
Lorraine S
LS
Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA. lwallace@mc.utmck.edu
DeVoe
Jennifer E
JE
Rogers
Edwin S
ES
Malagon-Rogers
Maricarmen
M
Fryer
George E
GE
D000328:Adult; D000368:Aged; D003142:Communication; D003657:Decision Making; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D026706:Paternalism; D010817:Physician-Patient Relations; D014481:United States