Perceived Discrimination and Self-Reported Quality of Care Among Latinos in the United States

BACKGROUND: Given the persistence of health and health-care disparities among Latinos in the United States and evidence that discrimination affects health and health care, an investigation of the relationship between perceived discrimination and quality of health care among Latinos is warranted. OBJECTIVE: To examine the relationship of perceived discrimination (in general and in regard to doctors and medical personnel) with self-reported quality of health care and doctor-patient communication in a nationally representative Latino population sample. PARTICIPANTS: Participants were 1,067 Latino adults aged >or=18 years living in the US selected via random-digit dialing. Telephone interviews were conducted in 2008 during Wave 2 of the Pew Hispanic Center/Robert Wood Johnson Foundation Hispanic Healthcare Survey. RESULTS: US-born Latinos were twice as likely to report general discrimination as foreign born: 0.32 SD versus -0.23 SD (P < 0.001) on the Detroit Area Survey (DAS) discrimination scale. Higher DAS discrimination was associated with lower self-reported quality of care in US-born Latinos OR = 0.5; 95% CI (0.3, 0.9); P = 0.009. For foreign-born Latinos, report of any doctor or medical staff discrimination was associated with lower quality of care OR = 0.5; 95% CI (0.3, 0.9); P = 0.03, but the DAS was not. For US-born Latinos, doctor discrimination and higher DAS were jointly associated with worse doctor-patient communication. For foreign-born Latinos, the effect of discrimination on doctor-patient communication was significantly smaller than that observed in US-born Latinos. CONCLUSIONS: Given the association between perceived discrimination and quality of care, strategies to address discrimination in health-care settings may lead to improved patient satisfaction with care and possibly to improved treatment outcomes.