The Predictors of Patient–Physician Race and Ethnic Concordance: A Medical Facility Fixed‐Effects Approach

Ana H. Traylor · Julie A. Schmittdiel · Connie S. Uratsu · Carol M. Mangione · Usha Subramanian

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Diversity and Career in Medicine Patient-Provider Communication in Healthcare Cultural Competency in Health Care

Abstract

OBJECTIVE: To examine the predictors of patient-physician race/ethnicity concordance among diabetes patients in an integrated delivery system. DATA SOURCE: Kaiser Permanente's Northern California Diabetes Registry of 2005. STUDY DESIGN: Logistic regression predicted concordance for each racial/ethnic group. Availability of a concordant physician, whether a patient chose their physician, and patient language were main explanatory variables. DATA COLLECTION/EXTRACTION METHODS: The study population consisted of 109,745 patients and 1,750 physicians. PRINCIPAL FINDINGS: Patients who chose their physicians were more likely to have a same race/ethnicity physician with OR of 2.2 (95 percent CI 1.74-2.82) for African American patients, 1.71 (95 percent CI 1.44-2.04) for Hispanic patients, 1.11 (95 percent CI 1.04-1.18) for white patients, and 1.38 (95 percent CI 1.23, 1.55) for Asian patients. Availability of a same race/ethnicity physician was also a predictor of concordance for African American patients (OR 2.7; 95 percent CI 2.45-2.98) and marginally significant for Hispanic patients (OR 1.02; 95 percent CI 1.01-1.02), white patients (OR 1.02; 95 percent CI 1.00-1.04), and Asian patients (OR 1.05; 95 percent CI 1.03, 1.07). Limited English language was a strong predictor of concordance for Hispanic patients (OR 4.81; 95 percent CI 4.2-5.51) and Asian patients (OR 9.8; 95 percent CI 7.7, 12.6). CONCLUSION: Patient language, preferences, and the racial composition of the physician workforce predict race/ethnicity concordance.

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2004Primary Care Physicians Who Treat Blacks and Whites 2004Unequal Treatment—Confronting Racial and Ethnic Disparities in Healthcare 2002Research on the Provider Contribution to Race/Ethnicity Disparities in Medical Care 1995Physician Race and Care of Minority and Medically Indigent Patients 2000Do Patients Choose Physicians Of Their Own Race?1997The Effects of Ethnicity and Language on Medical Outcomes of Patients with Hypertension or Diabetes 2005Patients' Beliefs About Racism, Preferences for Physician Race, and Satisfaction With Care 1997The relationship between the race/ethnicity of generalist physicians and their care for underserved populations.

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