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Background <p>Black people are more likely to have hypertension and report lower quality of care than White people. Patient-provider race concordance could improve perceived quality of care, potentially lessening disparities.</p> Objective <p>Investigate the association between patient-provider race concordance and patient-perceived quality of chronic disease care, as measured by the Patient Assessment of Chronic Illness Care (PACIC) scale.</p> Design <p>Cross-sectional analysis of baseline data from a randomized trial with Black patients with persistently uncontrolled hypertension.</p> Setting <p>Participants received care at one of 69 rural primary care practices in Alabama and North Carolina.</p> Participants <p>Three hundred and ninety-one Black patients with persistently uncontrolled hypertension enrolled in the Southeastern Collaboration to Improve Blood Pressure Control (SEC) trial.</p> Main Measure <p>PACIC overall scores and subscale scores (<i>patient activation</i>, <i>delivery system</i>, <i>goal setting, problem solving</i>, <i>follow-up</i>).</p> Results <p>Of 1592 patients enrolled in the SEC trial, 391 participants self-reported race concordance data and completed the PACIC. Most participants were age &lt; 60 (52.4%), 65.2% identified as women, and 50.1% were beneficiaries of either Medicare or Medicaid. Those with patient-provider race concordance reported higher overall PACIC scores (58.8% vs 46.1%, <i>p</i> &lt; 0.05), with higher sub-scores of goal setting (60.9% vs 46.8%, <i>p</i> &lt; 0.05) and problem-solving (62.7% vs 48.0%,<i> p</i> &lt; 0.05) compared to those without race concordance. Poisson regression models of participants age ≥ 60&#xa0;years demonstrated that those with race concordance were more likely to have higher overall PACIC scores (RR 1.53, 95% CI 1.17–2.0, <i>p</i> = 0.002), goal-setting subscale scores (RR 1.63, 95% CI 1.24–2.15, <i>p</i> = 0.0005), and problem-solving subscale scores (RR 1.66, 95% CI 1.29–2.14, <i>p</i> &lt; 0.0001). Those &lt; 60&#xa0;years of age had no significant findings comparing those with and without race concordance.</p> Conclusions <p>Older&#xa0;Black patients perceived greater quality of care if their providers were also Black.</p> Visual abstract <p></p>

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Patient Perceptions of Provider Race Concordance and Quality of Chronic Illness Care

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月22日

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  • Benjamin Grant,
  • Orysya Soroka,
  • Elizabeth Baquero,
  • Joanna Bryan Ringel,
  • Andrea Cherrington,
  • Doyle M. Cummings,
  • Jacqueline R. Halladay,
  • Arvind Rajan,
  • Monika M. Safford

摘要

Background

Black people are more likely to have hypertension and report lower quality of care than White people. Patient-provider race concordance could improve perceived quality of care, potentially lessening disparities.

Objective

Investigate the association between patient-provider race concordance and patient-perceived quality of chronic disease care, as measured by the Patient Assessment of Chronic Illness Care (PACIC) scale.

Design

Cross-sectional analysis of baseline data from a randomized trial with Black patients with persistently uncontrolled hypertension.

Setting

Participants received care at one of 69 rural primary care practices in Alabama and North Carolina.

Participants

Three hundred and ninety-one Black patients with persistently uncontrolled hypertension enrolled in the Southeastern Collaboration to Improve Blood Pressure Control (SEC) trial.

Main Measure

PACIC overall scores and subscale scores (patient activation, delivery system, goal setting, problem solving, follow-up).

Results

Of 1592 patients enrolled in the SEC trial, 391 participants self-reported race concordance data and completed the PACIC. Most participants were age < 60 (52.4%), 65.2% identified as women, and 50.1% were beneficiaries of either Medicare or Medicaid. Those with patient-provider race concordance reported higher overall PACIC scores (58.8% vs 46.1%, p < 0.05), with higher sub-scores of goal setting (60.9% vs 46.8%, p < 0.05) and problem-solving (62.7% vs 48.0%, p < 0.05) compared to those without race concordance. Poisson regression models of participants age ≥ 60 years demonstrated that those with race concordance were more likely to have higher overall PACIC scores (RR 1.53, 95% CI 1.17–2.0, p = 0.002), goal-setting subscale scores (RR 1.63, 95% CI 1.24–2.15, p = 0.0005), and problem-solving subscale scores (RR 1.66, 95% CI 1.29–2.14, p < 0.0001). Those < 60 years of age had no significant findings comparing those with and without race concordance.

Conclusions

Older Black patients perceived greater quality of care if their providers were also Black.

Visual abstract