title: Racial and Ethnic Minority Concentration in Veterans Affairs Facilities and Delivery of Patient-Centered Primary Care.
abstract: Despite patient-centered medical home implementation by the Veterans Health Administration (VHA), delivery of patient-centered care varies across VHA facilities. Facility characteristics underlying this variation are not fully understood. This study used administrative data from 908 VHA outpatient facilities to examine the association of racial and ethnic minority patient concentration and other facility characteristics with facility ratings of patient-centered care. The primary finding was that patient-centered ratings were lower for facilities with medium or high concentrations of Hispanic patients (medium: estimate [Est] = -0.40, standard error [SE] = 0.20, P = 0.046; high: Est = -0.99, SE = 0.23, P < 0.001). In addition, patient-centered ratings decreased as patient panel sizes increased, especially among facilities with higher concentrations of black patients. This study indicates that efforts to improve patient-centered care may be needed at VHA facilities that serve Hispanic and VHA facilities with large panel sizes of high concentrations of black patients.
authors: 1 Veterans Affairs Pittsburgh Healthcare System, Center for Health Equity Research and Promotion (CHERP) , Pittsburgh, Pennsylvania.|2 Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors: Leslie R M
authors: LRM
authors: Hausmann
authors: 3 Veterans Integrated Service Network 4 Center to Evaluate Patient Aligned Care Teams (CEPACT) , Philadelphia, Pennsylvania.
authors: Anne
authors: A
authors: Canamucio
authors: 1 Veterans Affairs Pittsburgh Healthcare System, Center for Health Equity Research and Promotion (CHERP) , Pittsburgh, Pennsylvania.
authors: Shasha
authors: S
authors: Gao
authors: 1 Veterans Affairs Pittsburgh Healthcare System, Center for Health Equity Research and Promotion (CHERP) , Pittsburgh, Pennsylvania.
authors: Audrey L
authors: AL
authors: Jones
authors: 3 Veterans Integrated Service Network 4 Center to Evaluate Patient Aligned Care Teams (CEPACT) , Philadelphia, Pennsylvania.
authors: Shimrit
authors: S
authors: Keddem
authors: 3 Veterans Integrated Service Network 4 Center to Evaluate Patient Aligned Care Teams (CEPACT) , Philadelphia, Pennsylvania.|4 Corporal Michael J. Crescenz Veterans Affairs Medical Center, Center for Health Equity Research and Promotion (CHERP) , Philadelphia, Pennsylvania.|5 Divison of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Judith A
authors: JA
authors: Long
authors: 3 Veterans Integrated Service Network 4 Center to Evaluate Patient Aligned Care Teams (CEPACT) , Philadelphia, Pennsylvania.|4 Corporal Michael J. Crescenz Veterans Affairs Medical Center, Center for Health Equity Research and Promotion (CHERP) , Philadelphia, Pennsylvania.|5 Divison of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors: Rachel
authors: R
authors: Werner
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006787:Hospitals, Veterans / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*