Racial and Ethnic Minority Concentration in Veterans Affairs Facilities and Delivery of Patient-Centered Primary Care

• Published in: Population health management Vol. 20; no. 3; p. 189
• Main Authors: Hausmann, Leslie R M, Canamucio, Anne, Gao, Shasha, Jones, Audrey L, Keddem, Shimrit, Long, Judith A, Werner, Rachel
• Format: Journal Article
• Language: English
• Published: United States 01-06-2017
• Subjects: Continental Population Groups - statistics & numerical data; Cross-Sectional Studies; Female; Hispanic Americans - statistics & numerical data; Hospitals, Veterans - standards; Hospitals, Veterans - statistics & numerical data; Humans; Male; Patient Satisfaction - statistics & numerical data; Patient-Centered Care - statistics & numerical data; United States - epidemiology; Veterans - statistics & numerical data
• ISSN: 1942-7905
• DOI: 10.1089/pop.2016.0053

Despite patient-centered medical home implementation by the Veterans Health Administration (VHA), delivery of patient-centered care varies across VHA facilities. Facility characteristics underlying this variation are not fully understood. This study used administrative data from 908 VHA outpatient facilities to examine the association of racial and ethnic minority patient concentration and other facility characteristics with facility ratings of patient-centered care. The primary finding was that patient-centered ratings were lower for facilities with medium or high concentrations of Hispanic patients (medium: estimate [Est] = -0.40, standard error [SE] = 0.20, P = 0.046; high: Est = -0.99, SE = 0.23, P < 0.001). In addition, patient-centered ratings decreased as patient panel sizes increased, especially among facilities with higher concentrations of black patients. This study indicates that efforts to improve patient-centered care may be needed at VHA facilities that serve Hispanic and VHA facilities with large panel sizes of high concentrations of black patients.