Date of Conferral

2021

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

Chester Jones

Abstract

AbstractPrior research has shown that African Americans have less access to healthcare than do White Americans. The study’s purpose was to determine the association between race/ethnicity and quality care measures in a population of Medicare recipients with Type 2 diabetes, aged 65 75 years and over. Covariates predicted satisfaction with doctor care, compassionate doctor care, and indifferent doctor care using Andersen’s health behavior theory. The Medicare Current Beneficiary Survey (MCBS) sample consisted of 1,716 people with Type 2 diabetes, with most (76.6%) being non-Hispanic Whites, and the remainder non-Hispanic Blacks (10.8%) and Hispanics (12.6%). Race/ethnicity were associated with quality-of-care measures assessed by one-way analysis of variance, with multiple regression showing racial and ethnic differences. Satisfaction with doctor care was higher for Hispanic Americans under 75 years of age, respondents who were male, and those who had fewer than 4.5 chronic conditions, F(7, 1708) = 9.30, p = .001, R² = .037. No racial/ethnic differences were shown on compassionate doctor care, although increased adherence existed for all groups, F(7, 1708) = 3.09, p = .003, R² = .013. Indifferent doctor care revealed racial/ethnic differences between the three groups. Differences were higher for Hispanic respondents and those with more chronic conditions and low adherence frequency, F(7, 1708) = 4.64, p = .001, R² = .019. Differences found that enhance the positive social change imperative of providing care through the patient-centered medical home may compel further research. Policymakers should consider this innovative model to reduce healthcare disparities.

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