A discrete-choice logit model was applied to study the determinants of mental health provider choice using data from a large urban county in the Northeast US. The study subjects were 9,544 adult Medicaid recipients who received outpatient treatment from the 20 Community Mental Health Center (CMHC) programs in 2001. In addition to a conventional set of variables representing client and provider characteristics, the regression model included several interaction terms to examine whether racial concordance level among patients influences the choice of an outpatient program. The results revealed that racial concordance among the clients seems to be a factor in choosing a program. In particular, Caucasian clients are much more likely to select a program with a higher percentage of Caucasian clients, even though they have to travel further. More generally, our results suggest that program choice may be driven more by the racial composition of the clients served than by spatial proximity to the program.
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http://dx.doi.org/10.1007/s10729-011-9164-9 | DOI Listing |
J Surg Educ
January 2025
Division of Vascular and Endovascular Surgery, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Objectives: Race and gender concordance between physicians and patients is associated with reductions in healthcare disparities. However, the diversity of the medical workforce does not mirror the population; some of the greatest deficiencies exist in the surgical workforce. We conducted a pilot study focused on early recruitment of diverse college students in our region, with a concurrent needs assessment of their specific barriers to entering the field of surgery.
View Article and Find Full Text PDFMed Care
February 2025
RAND, Health Care, Santa Monica, CA.
Background: Medicare Bayesian Improved Surname and Geocoding (MBISG), which augments an imperfect race-and-ethnicity administrative variable to estimate probabilities that people would self-identify as being in each of 6 mutually exclusive racial-and-ethnic groups, performs very well for Asian American and Native Hawaiian/Pacific Islander (AA&NHPI), Black, Hispanic, and White race-and-ethnicity, somewhat less well for American Indian/Alaska Native (AI/AN), and much less well for Multiracial race-and-ethnicity.
Objectives: To assess whether temporal inconsistency of self-reported race-and-ethnicity might limit improvements in approaches like MBISG.
Methods: Using the Medicare Health Outcomes Survey (HOS) baseline (2013-2018) and 2-year follow-up data (2015-2020), we evaluate the consistency of self-reported race-and-ethnicity coded 2 ways: the 6 mutually exclusive MBISG categories and individual endorsements of each racial-and-ethnic group.
Fam Med
November 2024
Department of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD.
Background And Objectives: Black/African American medical professionals and students engage in patient-centered communication in ways that are not yet described in medical education literature. The purpose of this paper is to explore the ways in which Black/African American attending physicians, residents, and medical students enact patient-centered communication while interacting with their Black/African American patients.
Methods: Forty-one Black/African American attending physicians, residents, and medical students were recruited through a snowball sample of the authors' personal and professional networks.
Health Aff (Millwood)
January 2025
Amal N. Trivedi, Brown University and Providence Veterans Affairs Medical Center, Providence, Rhode Island.
Black and Hispanic patients who receive care from Black and Hispanic physicians have greater use of preventive care. However, receiving care from racially concordant physicians requires that such physicians are included in private insurance plan networks. Using data from 2019, we examined the extent to which racially concordant physicians are available in the Medicare Advantage (MA) program, which disproportionately enrolls Black and Hispanic Medicare beneficiaries, by linking MA physician networks to physician race and ethnicity to measure the diversity of in-network physicians.
View Article and Find Full Text PDFJTO Clin Res Rep
January 2025
Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa.
Introduction: Despite efforts to achieve health care equality, racial/ethnic disparities persist in lung cancer survival in the United States, with non-Hispanic Black patients experiencing higher mortality compared with non-Hispanic Whites. Previous research often focused on single treatments, overlooking the broad range of options available. We aimed to highlight disparities in survival and receipt of comprehensive lung cancer treatment by developing a guideline-concordant initial treatment (GCIT) indicator based on disease stage and recommended treatment.
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