Patient-reported confidence in primary healthcare: are there disparities by ethnicity or language?

Objective: To examine whether confidence in primary healthcare (PHC) differs among ethnic-linguistic groups and which PHC experiences are associated with confidence.

Design: A cross-sectional study where patient surveys were administered using random digit dialling. Regression models identify whether ethnic-linguistic group remains significantly associated with confidence in PHC.

Setting: British Columbia, Canada.

Main Outcome Measures: Confidence in PHC measured using a 0-10 scale, where a higher score indicates increased confidence in the ability to get needed PHC services.

Participants: Community-dwelling adults in the following ethnic-linguistic groups: English-speaking Chinese, Chinese-speaking Chinese, English-speaking South Asians, Punjabi-speaking South Asians and English-speakers of presumed European descent.

Findings: Based on a sample of 1211 respondents, confidence in PHC differed by ethnicity and the ability to speak English. Most of the differences in confidence by ethnic-linguistic group can be explained by various aspects of care experience. Patient experiences associated with lower confidence in PHC were: if care was received outside Canada, having to wait months to see their regular doctor and rating the quality of healthcare as good or fair/poor. Better patient experiences of their doctor being concerned about their feelings and being respectful and if they found wait times acceptable were associated with higher levels of confidence in PHC. The final regression model explained 30% of the variance.

Conclusions: Improving the delivery of PHC services through positive interactions between patients and their usual provider and acceptability of wait times are examples of how the PHC system can be strengthened.