Health Care Disparities: Patient Perspectives on Navigating the Healthcare System

Background

Disparities in healthcare outcomes based on race/ethnicity and socioeconomic status have been well documented. There is significant evidence of poor health status among racial/ethnic minority populations with respect to premature death and preventable disease.1 Current policy initiatives, including Healthy People 2010, further recognize the importance of income disparities in determining health outcomes, stating in general, population groups that suffer the worst health status also are those that have the highest poverty rate and the least education.2

Objectives

  • Identify predictors of negative health outcomes and patient dissatisfaction
  • Gather data from both healthcare case managers and consumers
  • Examine the experiences of patients of different socioeconomic levels and races

Population

Healthcare case managers, healthcare consumers who have a primary care home, lack a primary care home, and who are mentally ill.

Design

  • Cross sectional study
  • Six focus groups (n=25)
  • Participants were racial minorities and individuals with public health insurance
  • Administered pre-focus group survey

Quantitative Findings

  • Correlation between satisfaction and having a primary care home
  • Desire for education about insurance policies and navigating the health system

Qualitative Findings (major themes)

  • Socioeconomic and racial barriers to care
  • Insurance coverage including: the need for transportation, medication, and testing
  • Lack of choice in public health plans
  • Need for personal accountability
  • Lack of understanding of the system or communication gaps

Timeline

May 2007-Current

Accomplishments

Bade, E., Evertsen, J., Smiley, S. (2008). Health Care Disparities: Patient perspectives on navigating the health care system. Paper presentation at the North American Primary Care Research Group, Rio Grande, Puerto Rico (November).

Bade, E., Evertsen, J., Smiley, S. (2008). Health Care Disparities: Patient perspectives on navigating the health care system. Oral presentation at the Wisconsin Research and Education Network Forum, Wisconsin Dells, WI (November).

Bade, E., Evertsen, J., Smiley, S. (2009). Health Care Disparities: Patient perspectives on navigating the health care system. Wisconsin Medical Journal,107(8), 374-379.

Investigator & Staff

Aurora UW Medical Group

  • Elizabeth Bade, M.D.

Milwaukee Health Department

  • Sabrina Smiley, M.P.H.

Center for Urban Population Health

  • Jennifer Evertsen, M.S.

1 The Office of Minority Health. 2007. "About the National Action Agenda to End Health Disparities for Racial and Ethnic Minority Populations." Rockville, MD: The Office of Minority Health. Retrieved 9/5/07.

2 US Department of Health and Human Services. 2000. "Healthy People 2010: A Systematic Approach to Health Improvement." Washington, DC: US DHHS. Retrieved 9/5/07.