Elsevier

Social Science & Medicine

Volume 63, Issue 12, December 2006, Pages 3060-3066
Social Science & Medicine

Patient–physician racial and ethnic concordance and perceived medical errors

https://doi.org/10.1016/j.socscimed.2006.08.015Get rights and content

Abstract

In this paper, I use nationally representative survey data to examine the relationship between patient–physician racial/ethnic concordance and perceived medical errors in the USA. After adjusting for potential confounding factors, we find that White patients treated by White physicians have 33% lower odds of reporting medical errors than White patients treated by non-White physicians. In contrast, patient–physician racial/ethnic concordance has no effect on perceived medical errors among non-White patients. The results suggest that the role of racial/ethnic concordance in perceptions of health care safety varies by patients’ racial/ethnic background.

Section snippets

Main text

Medical errors represent a serious threat to patient safety. Deaths resulting from medical errors in the United States range from 44,000 to 98,000 annually, exceeding those resulting from AIDS or motor vehicle accidents (Institute of Medicine, 1999). A more recent estimate of 225,000 deaths from errors and adverse effects makes iatrogenic events the third leading cause of death, exceeded only by heart disease and cancer (Starfield, 2000). The incidences of adverse events range between 3% and

Data

2001 Survey on Disparities in Quality of Health Care, sponsored by The Commonwealth Fund, is a random-digit-dial telephone survey with 6722 adults (age 18 and older) residing in the continental United States. Telephone numbers from areas with a higher than average density of minority residents were over-sampled. Respondents reported their sources of, access to, and utilization of health care; experiences with health care; and socio-demographic characteristics. Since only respondents who

Measures

Respondents were asked, “Have you or any family member ever gotten sick or gotten worse as a result of going to the doctor's office or being hospitalized?” Those who answered in the affirmative were asked, “Do you think this was due to a mistake made at the doctor's office or hospital?” Perceived medical errors were coded as 1 for respondents who answered yes to both these questions and 0 for all others.

Respondents’ reported their ethnicity (Hispanic or non-Hispanic) and race (White, Black,

Analytic strategy

After conducting univariate, bivariate and missing data analyses, I estimated multivariate logistic regression models assessing the relationships between perceived medical errors and patient–physician racial/ethnic concordance. To prevent potential bias, I controlled for correlates of perceived medical errors that are also related to the main explanatory variable, physician–patient racial/ethnic concordance. Control variables included the usual place of care, education, income, insurance

Results

Univariate and bivariate statistics by racial/ethnic/language groups appear in Table 1. On average, one in 10 respondents reported having experienced medical errors personally or in their families. The probabilities of reporting medical errors were similar across racial/ethnic/language groups, except for Hispanics interviewed in Spanish, who were less likely to report medical errors than Whites. Compared to White patients, minority patients were less likely to see a physician of a matching

Discussion

Previous research on race/ethnicity and perceived medical errors has been inconclusive. Studies failing to find racial/ethnic differences in perceived medical errors (i.e., The Kaiser Family Foundation, 2004) or showing that bivariate racial/ethnic differences dissipate in multivariate analysis (i.e., Adams & Boscarino, 2004) stand in contrast to evidence that minority patients receive less safe care compared to White patients (i.e., Coffey, Andrews, & Moy, 2005) and are more concerned about

Acknowledgment

I would like to thank The Commonwealth Fund for providing the data and Karen S. Cook for feedback on previous drafts of this paper.

References (17)

  • R.E. Adams et al.

    A community survey of medical errors in New York

    International Journal of Quality in Health Care

    (2004)
  • H.B. Beckman et al.

    The doctor–patient relationship and malpractice. Lessons from plaintiff depositions

    Archives of Internal Medicine

    (1994)
  • J. Berger et al.

    Status characteristics and social interaction

    American Sociological Review

    (1972)
  • R.J. Blendon et al.

    Views of the public and practicing physicians on medical errors

    New England Journal of Medicine

    (2002)
  • R.M. Coffey et al.

    Racial, ethnic, and socioeconomic disparities in estimates of AHRQ patient safety indicators

    Medical Care

    (2005)
  • L. Cooper-Patrick et al.

    Race, gender, and partnership in the patient–physician relationship

    JAMA

    (1999)
  • J.A. Garcia et al.

    Patient preferences for physician characteristics in university-based primary care clinics

    Ethnicity and Disease

    (2003)
  • To Err is Human: Building a Safer Health Care System

    (1999)
There are more references available in the full text version of this article.

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