Patient Satisfaction and Ethnic Identity Among American Indian Older Adults.

African, Hispanic and Asian American patients often report lower satisfaction with medical care than White Americans. However, virtually no quantitative studies investigate patient satisfaction among American Indians. The degree to which American Indians are satisfied with their medical relationships is unknown, as is the degree to which satisfaction is associated with ethnic identity after other variables are controlled. This project collected survey data from 115 chronically ill American Indian patients ≥ 50 years at a clinic operated in Oklahoma by the Cherokee Nation. Regression analysis showed that strength of patients' ethnic identification (American Indian or White American) was significantly associated with satisfaction. Patients who scored high on the measure of American Indian ethnic identity were significantly less satisfied with their health care providers' interpersonal skill and attentiveness, while patients who scored high on a separate measure of White American ethnic identity were significantly more satisfied with the provider's interpersonal skill. There were no differences in satisfaction with provider's technical skill or shared decision-making, regardless of ethnic identification. Other variables associated with one or more dimensions of satisfaction included patient's age, number of previous visits, and wait time. All associations remained significant after controlling for patients' sex, education, marital status, self-reported health, and for provider's sex, age, and race. Our findings can inform scholarship and policy in the field of cultural competency. They also illustrate the importance of using measures of ethnic identity in studies of medical satisfaction, rather than usual measures of categorical race. [ABSTRACT FROM AUTHOR]