The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes

David M. Cykert, Joni S. Williams, Rebekah J. Walker, Kimberly S. Davis, Leonard E. Egede
2017 Journal of diabetes and its complications  
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, patent-centeredness, and dissatisfaction with care in adults with type 2 diabetes. Methods-602 patients from two primary care clinics in Charleston SC. Linear regression models assessed associations between perceived discrimination
more » ... d quality of care, patientcentered 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 61.5 years, 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.
doi:10.1016/j.jdiacomp.2016.09.012 pmid:27769800 pmcid:PMC5209248 fatcat:k4o24p3wxvdvxpl6u7rodjjhni