Patient–physician racial and ethnic concordance and perceived medical errors
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.
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