Unequal Treatment Confronting Racial and Ethnic Disparities in Health Care (2003) / Chapter Skim
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8. Needed Research
8. Needed Research
Pages 235-243
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From page 235... ...
and several private foundations (for a more thorough description of ongoing federal and private research and intervention efforts to address racial and ethnic disparities in care, see Federal and Private Initiatives to Reduce Healthcare Disparities in the appendix of this volume)
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From page 236... ...
Such data will also assist in determining if physicians experience greater uncertainty in assessing presenting complaints of cultural or linguistic minority patients, or if their treatment decisions for these patients fail to correspond to accepted standards of care. Beyond prospective studies of healthcare service delivery, additional research is needed on provider decision-making, heuristics employed in diagnostic evaluation, and how patients' race, ethnicity, gender, and social class may influence these decisions.
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From page 237... ...
Further, strategies to increase minority patients' ability to participate in treatment decisions and empower them as self-advocates within healthcare systems should be evaluated. It is important that these research efforts be conducted in active collaboration with racial and ethnic minority communities, both to avoid the perception that patients are to blame for unequal or poor treatment in healthcare settings, as well as to tap into cultural knowledge and traditions that may serve as sources of strength in the effort to "activate" patients.
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From page 238... ...
Future research should seek to illuminate the conditions of health systems, including factors such as co-payment and accessibility that may be associated with racial and ethnic disparities in care. Type of Hospital or Clinic and Racial and Ethnic Disparities in Care Several studies find differences as to where racial and ethnic minorities receive care, even when holding insurance status constant.
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From page 239... ...
To better understand sources of racial and ethnic disparities in care, future research should analyze the experience, qualifications, specialties, and other attributes of providers who disproportionately serve racial and ethnic minority patients and to assess whether these factors may in part explain racial and ethnic dispari.
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From page 240... ...
Several promising strategies have been identified that should continue to be the focus of research efforts, such as comprehensive cross-cultural education and communication training for healthcare providers. Research should assess not only the effectiveness of these interventions in reducing racial and ethnic gaps in appropriate care, but also their cost-effectiveness and the extent to which these interventions result in organizational and institution-level changes to improve care for minority patients.
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From page 241... ...
UNDERSTANDING THE CONTRIBUTION OF HEALTHCARE TO HEALTH OUTCOMES AND THE HEALTH GAP BETWEEN MINORITY AND NON-MINORITY AMERICANS As noted earlier in this report, health status disparities observed between many minority and non-minority populations in the United States likely reflect a complex interplay of social, economic, biologic, and environmental factors. While some evidence suggests that preventive and primary care services can have a greater impact on improving health status for low-income than middle- and higher-income individuals, the contribution of healthcare disparities to health status differences between minority and non-minority populations remains unknown.
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From page 242... ...
Research is needed to illuminate how and why racial and ethnic disparities in care occur and to test intervention strategies to eliminate them. Specifically, research is needed to: · Better understand the relative contribution of patient, provider, and institutional characteristics to healthcare disparities; · Further illuminate provider decision-making, heuristics employed in diagnostic evaluation, and how patients' race, ethnicity, gender, and social class may influence these decisions; · Assess the relative contributions of provider biases, stereotyping, prejudice, and uncertainty in producing racial and ethnic disparities in diagnosis, treatment, and outcomes of care;
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From page 243... ...
exposure to discriminatory practices by providers or systems; · Develop methods for monitoring progress toward eliminating racial and ethnic disparities in healthcare; and · Understand the relationship between healthcare disparities and the health gap between minority and non-minority Americans. Finally, it is apparent that efforts to eliminate healthcare disparities will benefit from efforts to better address barriers to research and intervention.
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