ARE COMMUNITY HELATH CENTERS SPACES FOR PATIENT-CENTERED CARE? USING INTERSECTIONALITY TO UNCOVER THE QUALITY OF PHYSICIAN CARE FOR HISPANIC/LATINX SUBGROUPS

dc.contributor.advisor Zheng, Wei
dc.contributor.author Floyd, Megan Leslie
dc.contributor.department Sociology
dc.date.accessioned 2019-07-02T18:03:42Z
dc.date.available 2019-07-02T18:03:42Z
dc.date.issued 2019
dc.description.degree M.A.
dc.identifier.uri http://hdl.handle.net/10125/63265
dc.subject Medicine
dc.subject Sociology
dc.subject Public health
dc.subject Community Health Centers
dc.subject Hispanic/Latinx
dc.subject Intersectionality
dc.subject Patient-Centered Care
dc.title ARE COMMUNITY HELATH CENTERS SPACES FOR PATIENT-CENTERED CARE? USING INTERSECTIONALITY TO UNCOVER THE QUALITY OF PHYSICIAN CARE FOR HISPANIC/LATINX SUBGROUPS
dc.type Thesis
dcterms.abstract Community health centers are private non-profits, federally designed to provide quality and affordable healthcare for disadvantaged populations in the United States. Many of these community-based clinics have built into their mission statements, calls for patient-centered care: the practice of respecting a patients’ unique lived experiences. As Hispanic/Latinx are one of the largest groups served by this institution, and the largest minority group within the United States, it is vital that academic studies evaluate their quality of care. This paper addresses whether community health centers actively promote patient centered-care for Hispanic/Latinx female and SES subgroups. This paper is built upon a rich tradition of scholarship that has explored the quality of care using theories on patient-centered and paternalistic qualities of care within the United States healthcare system. While most of these works have used single-axis frameworks, more modern studies have incorporated theories of intersectionality. However, avenues of study remain largely unexplored. Only a few studies have been published on the role of community heath centers in promoting patient-centered care. Fewer have utilized data from the 2014 Health Center Survey- a comprehensive report on patient sociodemographic profiles, health outcomes, and quality of care. Despite this rich source, there has yet to be any published study on whether Hispanic/Latinx patients, across a wide spectrum of intersecting statuses, have reported patient-centered care at these clinics. Ordered logistic regression was used to determine the quality of doctor-patient interaction for Hispanic/Latinx groups (n=882) by gender, nativity, language, and socioeconomic statuses. Alpha and factor analysis was employed to aggregate the following measures into a single-12-point doctor-patient interaction scale that is used as the dependent variable: whether the doctor listened carefully to them, showed respect for patient input, provided easy-to-understand information, and spent adequate time with the client. Hispanic/Latinx across all categories reported positive doctor-patient interaction, compared to all other racial groups (n=2,042). The categories of female (p=.435), poor (p=.401), in poverty (p=.401), and unemployed (p=.611) showed no significant correlation. Hispanic/non-English speaking (p=.000**) and Hispanic/foreign-born (p=.000**) subgroups reported better quality of care. While these findings show that being Hispanic/Latinx, as well as the intersecting categories of non-English speaking and foreign-born are associated with positive doctor-patient interaction, future studies should be done to determine the underlying patterns behind these findings. In addition, it is vital that such studies continue to utilize both doctor-patient interaction and intersectionality theories. Further policies aimed at promoting patient-centered care at community health centers must also take into consideration the effects of multiple forms of adversity across all racial/ethnic categories.
dcterms.description M.A. Thesis. University of Hawaiʻi at Mānoa 2019
dcterms.extent 40 pages
dcterms.language eng
dcterms.publisher University of Hawai'i at Manoa
dcterms.rights All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
dcterms.type Text
local.identifier.alturi http://dissertations.umi.com/hawii:10155
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