Identifying healthcare experiences associated with perceptions of racial/ethnic discrimination among veterans with pain: A cross-sectional mixed methods survey.

摘要: Background Healthcare experiences associated with perceived racial/ethnic discrimination among patients are poorly understood. Objective Identify domains of patient dissatisfaction pain. Design Semi-structured telephone surveys completed in 2013–2015. Participants White, African American, and Latino participants who reported receiving pain management from 25 Veterans Affairs (VA) Medical Centers. Main measures Surveys included open-ended questions about healthcare satisfaction/dissatisfaction a measure racial/ethnic-based while seeking VA healthcare. Binary indicators for ten qualitative were derived questions. We used multilevel models to identify discrimination, adjusting characteristics site. Within we identified the most frequent codes examined whether primarily referenced clinical or non-clinical staff their experiences. Key results Overall, 622 (30.4% 37.8% 31.8% Latino; 57.4% female; mean age = 53.4) median score 1.0 (IQR: 1.0–1.3) on scale 1 5; 233 (37.5%) any Individually, 7 10 significantly discrimination: care quality, facilities, continuity care, interactions staff, demeanor, unresolved pain, pharmacy services (ps<0.005). In combined stratified by group, 3 remained statistically significant: poor Latinos (adjOR 5.24, 95% CI 2.28–12.06), negative demeanor Americans 2.82, 1.45–5.50), Whites 6.23, 2.39–16.28). Clinical more often than all (interactions: 51% vs. 30%; demeanor: 46% 15%; pain: 18% 1%, respectively). Conclusion Negative interpersonal strong correlates Future studies should test interventions targeting these reduce perceptions