updated 3/11/2008 12:10:27 AM ET 2008-03-11T04:10:27

Minorities are more likely than white patients to rate their health care as fair or poor, a view that is particularly true among Chinese-Americans, blacks born in Africa and Vietnamese-Americans.

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Researchers have long stressed that improving patients’ perception of their care is important to improving outcomes. That’s because negative experiences can lead to less time spent with a physician and poor communications between doctor and patient.

To get a more detailed view of the differing perceptions that patients have, researchers at Harvard University and the Robert Wood Johnson Foundation surveyed 4,334 adults last year. The researchers asked patients such questions as how quickly they were able to get an appointment the last time they were sick and whether their doctor explained things in a way the patient could understand. The researchers found that whites routinely rated their experience higher than did the minority patients, who still had largely favorable views of their care.

For example, 91 percent of whites rated their care as excellent or good. That percentage fell for most ethnic groups, with the lowest ratings recorded among Chinese-Americans, 74 percent; African-Americans born in Africa, 73 percent; and Vietnamese-Americans, 72 percent.

When it came to getting an appointment, about 63 percent of whites were able to get an appointment on the same day or the next day after they became sick or injured. That percentage dropped to 42 percent for Cuban-Americans and 39 percent for African-Americans born in the Caribbean.

About three-quarters of whites reported that their doctor listened carefully to them. That percentage fell to 62 percent for Korean-Americans and 58 percent for those from Central America or South America.

Previous research on disparities tended to take a broad look at the major ethnic groups even though group members often came from different countries. The Harvard study used much more detailed categories. For instance, there were three categories for African-Americans based on whether they were born in the Caribbean, Africa or the United States.

The researchers said the additional detail was important because the best ways to reduce disparities will reflect the unique experiences and needs of minority groups.

Dr. Anne Beal, assistant vice president at the Commonwealth Fund, said the latest study results are consistent with previous research of how minority patients view the quality of their health care. She said perception is reality when it comes to patients being treated with respect.

“Because the findings are so consistent, it’s not something where we can say it’s just about the patients,” Beal said. “They are reporting their experiences and the results should be taken seriously.”

Beal said the Harvard study also showed that there are steps that health care providers can take to improve patients’ perceptions, such as resolving language barriers. She said health care providers should incorporate translation services into their practice. Even physicians who work in small practices or on their own can make use of phone banks designed to improve doctor-patient communications.

Beal said doctors now pay for that service out of their own pocket, but that service should be reimbursable through government health programs such as Medicaid and Medicare.

The report will be published in the journal Health Affairs.

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