Does Managed Care Help Reduce Racial and Ethnic Disparities in Patients’ Experiences with Medical Care?

Few studies are available on racial/ethnic disparities in American adults' experiences with medical care. Especially little is known about whether managed care helps attenuate racial and ethnic disparities. The first goal of this study is to examine the role of racial/ethnic status in patients' experiences with medical care. Second, we investigate whether racial/ethnic disparities in patients' experiences differ by health care plan. Using a large nationally representative dataset, the Community Tracking Study Household Survey, we estimate a series of ordinal probit models of the effects of race/ethnicity and managed care on the following patient experiences: (1) how well the physician listened, (2) how well the physician explained, (3) how thorough the physician was, (4) how likely the physician was to refer to a specialist, and (5) how influenced the physician was by insurance rules. We control for sociodemographic variables, health status, and characteristics of health care. Black and Hispanic respondents report more negative experiences with medical care than whites. Minority racial/ethnic status has a stronger negative impact on patients' reports of the difficulty obtaining referrals to a specialist in non-HMO plans than in HMO plans. Similarly, the gap between Blacks' and whites' reports of how influenced their physician is by insurance rules is larger in non-HMO than in HMO plans. Our results suggest that while there clearly are racial/ethnic disparities in patients' experiences with care, managed care may help attenuate some aspects of these disparities. [ABSTRACT FROM AUTHOR]