title: Measurement of Perceived and Technical Quality of Care for Depression in Racially and Ethnically Diverse Groups.
abstract: Measurement of patient satisfaction is now considered essential for providing patient centered care and is an important tool for addressing health care disparities. However, little is known about how ethnically and racially diverse (ERD) groups differ in how they perceive quality, and widely used instruments for measuring perceived quality give little attention to cultural elements of care. This study examined the relationship between the culturally determined beliefs and expectations of four ERD groups (African Americans, Latinos, Portuguese-speakers, and Haitians, total N = 160) and the technical quality of treatment for depression provided in four "culturally-specific" primary care clinics. Using data from the Experiences of Care and Health Outcomes survey, chart reviews and focus groups, the study addressed a set of questions related to the psychometric properties of perceived care measures and the technical quality of care. The groups differed in preferred cultural elements except all preferred inclusion of religion. They did not differ in overall perceived quality. Technical quality was higher for Portuguese and Haitians than for African Americans and Latinos. Implications of group differences for measuring quality are discussed.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: H Stephen
authors.initials: HS
authors.lastname: Leff
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: Clifton
authors.initials: C
authors.lastname: Chow
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA. dwieman@hsri.org.|Human Services Research Institute (HSRI), 2336 Massachusetts Avenue, Cambridge, MA, 02140, USA. dwieman@hsri.org.
authors.forename: Dow A
authors.initials: DA
authors.lastname: Wieman
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Laysha
authors.initials: L
authors.lastname: Ostrow
authors.affiliation: Mauricio Gastón Institute for Latino Community Development and Public Policy, University of Massachusetts Boston, Boston, MA, USA.
authors.forename: Dharma E
authors.initials: DE
authors.lastname: Cortés
authors.affiliation: Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: Treniece
authors.initials: T
authors.lastname: Harris
mesh_terms: D000328:Adult; D003142:Communication; D003466:Cultural Characteristics; D054521:Cultural Competency; D003863:Depression / Q000208:ethnology* / Q000628:therapy*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000208:ethnology*; D010465:Perception; D011369:Professional-Patient Relations; D011787:Quality of Health Care / Q000592:standards*; D044469:Racial Groups / Q000523:psychology; D013997:Time Factors
keywords: Depression treatment; Ethnic groups; Healthcare quality assessment