Disparities in quality of health care Health equity

1 disparities in quality of health care

1.1 problems patient-provider communication
1.2 provider discrimination
1.3 lack of preventive care

disparities in quality of health care

health disparities in quality of care exist , based on language , ethnicity/race includes:

problems patient-provider communication

communication critical delivery of appropriate , effective treatment , care, regardless of patient’s race, , miscommunication can lead incorrect diagnosis, improper use of medications, , failure receive follow-up care. patient provider relationship dependent on ability of both individuals communicate. language , culture both play significant role in communication during medical visit. among patient population, minorities face greater difficulty in communicating physicians. patients when surveyed responded 19% of time have problems communicating providers included understanding doctor, feeling doctor listened, , had questions did not ask. in contrast, hispanic population had largest problem communicating provider, 33% of time. communication has been linked health outcomes, communication improves patient satisfaction leads improved compliance , improved health outcomes. quality of care impacted result of inability communicate health care providers. language plays pivotal role in communication , efforts need taken ensure excellent communication between patient , provider. among limited english proficient patients in united states, linguistic barrier greater. less half of non-english speakers need interpreter during clinical visits report having one. absence of interpreters during clinical visit adds communication barrier. furthermore, inability of providers communicate limited english proficient patients leads more diagnostic procedures, more invasive procedures, , on prescribing of medications. poor communication contributes poor medical compliance , health outcomes. many health-related settings provide interpreter services limited english proficient patients. has been helpful when providers not speak same language patient. however, there mounting evidence patients need communicate language concordant physician (not interpreter) receive best medical care, bond physician, , satisfied care experience. having patient-physician language discordant pairs (i.e. spanish-speaking patient english-speaking physician) may lead greater medical expenditures , higher costs organization. additional communication problems result decrease or lack of cultural competence providers. important providers cognizant of patients’ health beliefs , practices without being judgmental or reacting. understanding patients’ view of health , disease important diagnosis , treatment. providers need assess patients’ health beliefs , practices improve quality of care. patient health decisions can influenced religious beliefs, mistrust of western medicine, , familial , hierarchical roles, of white provider may not familiar with. other type of communication problems seen in lgbt health care spoken heterosexist (conscious or unconscious) attitude on lgbt patients, lack of understanding on issues having no sex men (lesbians, gynecologic examinations) , other issues.

provider discrimination

provider discrimination occurs when health care providers either unconsciously or consciously treat racial , ethnic patients differently other patients. may due stereotypes providers may have towards ethnic/racial groups. doctors more ascribe negative racial stereotypes minority patients. may occur regardless of consideration education, income, , personality characteristics. 2 types of stereotypes may involved, automatic stereotypes or goal modified stereotypes. automated stereotyping when stereotypes automatically activated , influence judgments/behaviors outside of consciousness. goal modified stereotype more conscious process, done when specific needs of clinician arise (time constraints, filling in gaps in information needed) make complex decisions. physicians unaware of implicit biases. research suggests ethnic minorities less whites receive kidney transplant once on dialysis or receive pain medication bone fractures. critics question research , further studies needed determine how doctors , patients make treatment decisions. others argue diseases cluster ethnicity , clinical decision making not reflect these differences.

lack of preventive care

according 2009 national healthcare disparities report, uninsured americans less receive preventive services in health care. example, minorities not regularly screened colon cancer , death rate colon cancer has increased among african americans , hispanic populations. furthermore, limited english proficient patients less receive preventive health services such mammograms. studies have shown use of professional interpreters have reduced disparities in rates of fecal occult testing, flu immunizations , pap smears. in uk, public health england, universal service free @ point of use, forms part of nhs, offers regular screening member of population considered in at-risk group (such individuals on 45) major disease (such colon cancer, or diabetic-retinopathy).