The authors point out that there is considerable evidence in other research that preventive, primary, and secondary interventions – the majority of which take place in the outpatient settings – can reduce or prevent the complications of most major chronic diseases, and minorities suffer disproportionately from these conditions.
In the study, "Variation in Participation in Health Care Settings Associated with Race and Ethnicity," the authors also listed possible factors why blacks and Hispanics don't receive care in some health care settings to the same degree whites do. These factors were culled from a review of research literature and include differing perceptions of the quality and availability of health care by minorities and whites, minorities' mistrust of the medical system, problems with low Medicaid reimbursements and provider nonparticipation, the racial and ethnic mix of the physician workforce, self-perception of better or worse health, and perception of the value of obtaining early and preventive health care.
"Research and programs aimed at reducing disparities in receipt of care specifically in the outpatient setting may have an important role in the quest to reduce racial and ethnic disparities," said lead author Erika Bliss, M.D., researcher for the Graham Center and a family physician with Carolyn Downs Family Medicine Center in Seattle.
"Gaps in the U.S. health care system result in 79,000 deaths each year because of a lack of preventive treatment and care for chronic conditions, according to a new report from the National Committee for Quality Assurance," pointed out Robert L. Phillips, Jr., MD, assistant director of the Graham Center and co-author of the study. "Closing those gaps has to include reducing disparities in how people use doctors' offices, where most people go for most of their health care most of the time."
The Journal of General Internal Medicine can be accessed at http://www.blackwellpublishing.com/journal.asp?ref=0884-8734&site=1.
The Robert Graham Center conducts research and analysis that brings a family medicine perspective to health policy deliberations in Washington. Founded in 1999, the Center is an independent research unit working under the personnel and financial policies of the American Academy of Family Physicians. For more information, please visit www.graham-center.org.
The information and opinions contained in research from the Robert Graham Center do not necessarily reflect the views or policy of the AAFP.
Journal
Journal of General Internal Medicine