Insurance policies and perceived quality of primary care among privately insured patients: do features of managed care widen the racial, ethnic, and language-based gaps?
Abstract
Little is known about whether some features of managed care widen disparities in patients' evaluations of primary care. We investigated whether the magnitudes of racial and ethnic/language-based differences in patients' evaluations of the quality of primary care vary by capitation and gatekeeping. We used a telephone survey of a representative sample of the US noninstitutionalized population, Community Tracking Study Household Survey 1998-1999, and Followback Survey of respondents' insurance administrators. Our sample was privately insured adults who saw a physician at least once during the year preceding the interview and whose last visit was to a primary care physician. We measured patients' evaluations of (1) how well the physician listened, (2) how well the physician explained, and (3) how thorough and careful the physician was during the last visit. Significant white-minority differences emerge more often in plans using capitation or gatekeeping than in other plans. The gaps in patients' evaluations of their primary care providers' (PCP) explanations and thoroughness between whites and Hispanics interviewed in English are larger when the PCP is capitated than when the PCP is not capitated. The gap in the evaluations of the...Continue Reading
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