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The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes. J Diabetes Complications 2017 01;31(1):175-179 PMID: 27769800 PMCID: PMC5209248

Pubmed ID

27769800

DOI

10.1016/j.jdiacomp.2016.09.012

Abstract

AIMS: Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patient-centeredness, and dissatisfaction with care in adults with type 2 diabetes.

METHODS: Six hundred two patients from two primary care clinics in Charleston, SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care. The models control for race, site, age, gender, marital status, duration of diabetes, education, hours worked weekly, income, and health status.

RESULTS: The mean age was 61.5years, with 66.3% non-Hispanic blacks, and 41.9% earning less than $20,000 annually. In final adjusted analyses, lower patient-centered care was associated with a higher discrimination score (β=-0.28; p=0.006), reporting at least 1 category of discrimination (β=-1.47; p=0.002), and reporting at least 2 categories of discrimination (β=-1.34; p=0.004). Dissatisfaction with care was associated with at least 2 categories of discrimination (β=0.45; p=0.002). No significant associations were seen with quality of care indicators.

CONCLUSIONS: Increased cumulative discrimination was associated with decreased feeling of patient-centeredness and increased dissatisfaction with care. However, these perceptions of discrimination were not significantly associated with quality indicators.

Author List

Cykert DM, Williams JS, Walker RJ, Davis KS, Egede LE

Authors

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Assistant Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD,MPH Assistant Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-85007531095

MESH terms used to index this publication - Major topics in bold

Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Models, Psychological
Patient Education as Topic
Patient Satisfaction
Patient-Centered Care
Primary Health Care
Quality Indicators, Health Care
Quality of Health Care
Self Report
Self-Management
Social Discrimination
South Carolina
Stress, Psychological
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e