Minority Physicians' Experiences Obtaining Referrals to Specialists and Hospital Admissions
August 9, 2001
ver the past 15 years, policy makers, health care providers and researchers have focused attention on understanding and reducing ethnic disparities in access to health care. Efforts to understand and reduce these disparities in access are driven by the wealth of studies that document significant differences in the health of ethnic minority groups in the United States.
The objective of this study was to assess differences in access to medical care from African-American, Hispanic and white physicians perspectives. Using the Community Tracking Study Physician Survey, a nationally representative survey of U.S. physicians, this study assesses physicians abilities to obtain medically necessary services for their patients. Physicians were asked how often they could arrange referrals to specialists and inpatient admissions for their patients.
Controlling for physician characteristics (e.g., providing charity care, participation in managed care, Medicaid, and Medicare) and community characteristics (e.g., average managed care participation, supply of hospital beds and specialists per capita) reduces the magnitude of differences between white and ethnic minority physicians. Nevertheless, after controlling for a wide range of practice and environmental characteristics, African-American physicians were more likely to report problems obtaining hospital admissions, and Hispanic physicians were more likely to report problems obtaining referrals to specialists, compared with white physicians.
In conclusion, disparities in ethnic minority physicians abilities to get medical services for their patients exist. This study corroborates that ethnic disparities are not limited to gaining access to primary health services (e.g., having a doctor visit or a usual source of medical care) but extend into the healthcare delivery system itself (e.g., getting a referral or hospital admission).
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J. Lee Hargraves, Jeffrey Stoddard, Sally Trude