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

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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.

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