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The relationship between cultural background and the experience of patients in primary care medical settings

Joseph A Greer, University of Massachusetts Amherst


The goals of the present study were to: (1) explore the extent to which Hispanic-American and European-American patients report different perceptions of primary care service quality and healthcare utilization patterns, and (2) identify within each ethnic group independent demographic, cultural, medical, and psychological predictors of perceptions of primary care service quality. Two hundred and ten (116 Hispanic-American and 94 European-American) adult primary care patients from three general medical settings completed questionnaires regarding their demographic information, perceptions of primary care service quality, participation in medical treatment decisions, general physical health, psychological wellbeing, level of acculturation, perceived discrimination, and healthcare utilization patterns. All questionnaires were translated into Spanish and English; participants unable to read or write were interviewed privately. Multiple linear regression analyses were conducted to examine mediators and moderators of the relation between patient predictor variables and perceptions of primary care services. Patient socioeconomic status mediated all differences between ethnic groups regarding perceptions of trust in medical providers, healthcare utilization patterns, as well as general physical and psychological health. Hispanic-American patients who were less acculturated in dominant society and who reported psychological distress or perceived life discrimination also indicated less satisfaction with the quality of primary care services they received. Psychologically distressed European-American patients who were younger or male were also more likely to perceive poorer medical services. Patients who participated more actively in treatment decision-making with providers reported higher ratings of primary care service quality, especially among the following patient groups: Hispanic Americans who were less acculturated in dominant society, Hispanic Americans who perceived greater life discrimination, and European Americans who indicated greater psychological distress. This study highlights the patient variables related to positive and negative perceptions of primary care services quality among Hispanic-American and European-American patients. In addition, these findings point to the physician behaviors that may enhance the relationship these patients share with their providers.

Subject Area

Psychotherapy|Public health

Recommended Citation

Greer, Joseph A, "The relationship between cultural background and the experience of patients in primary care medical settings" (2003). Doctoral Dissertations Available from Proquest. AAI3110493.