Using Standardized Encounters to Understand Reported Racial/Ethnic Disparities in Patient Experiences with Care

Published in: Medical Care, v. 46, no. 2, Apr. 2011, p. 491-509

Posted on RAND.org on January 01, 2010

by Robin M. Weinick, Marc N. Elliott, Angelo E. Volandes, Lenny Lopez, Q. Burkhart, Mark Schlesinger

Read More

Access further information on this document at onlinelibrary.wiley.com

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVE: To assess the extent to which racial/ethnic differences in ratings of patient experiences with health care represent true differences versus differences in expectations, how scales are used, or how identical physician-patient interactions are perceived by members of different groups. STUDY SETTING: Primary data collection from a nationally representative online panel (n=567), including white, African American, and Latino respondents. STUDY DESIGN: We administered questions on expectations of care, a series of written vignettes, a video-depicted doctor-patient interaction, and modified CAHPS Clinician and Group Doctor Communication items. PRINCIPAL FINDINGS: Different groups reported generally similar expectations regarding physicians' behaviors and provided similar mean responses to CAHPS communication items in response to standardized encounters. CONCLUSIONS: Preliminary evidence suggests that unlike more subjective global ratings, reported disparities in more specific and objective CAHPS composites may primarily reflect differences in experiences, rather than differences in expectations and scale use, adding to our confidence in using the latter to assess disparities.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.