Anita B. Varkey|Linda Baier Manwell|Eric S. Williams|Said A. Ibrahim|Roger Brown|James A. Bobula|Barbara A. Horner-Ibler|Mark D. Schwartz|Thomas R. Konrad|Jacqueline Wiltshire|Mark Linzer
Separate and Unequal
Loyola University Medical Center
studies examined influence physician workplace conditions health care disparities compared 96 primary care clinics new york new york upper midwest serving various proportions minority patients determine differences workplace organizational characteristicscrosssectional data surveys 96 clinic managers 388 primary care physicians 1701 adult patients hypertension diabetes mellitus congestive heart failure participating minimizing error maximizing outcome memo study data 27 clinics least 30 minority patients contrasted data 69 clinics less 30 minority patientscompared clinics serving less 30 minority patients clinics serving least 30 minority patients less access medical supplies 27 vs 34 p 001 referral specialists 30 vs 35 p 005 scale 1 none 4 great examination rooms per physician 22 vs 27 p 002 patients frequently depressed 228 vs 121 often covered medicaid 302 vs 114 report lower health literacy 37 vs 44 scale 1 low 5 high p 001 physicians clinics serving higher proportions minority populations perceive patients frequently speaking little english 271 vs 34 p 004 chronic pain 241 vs 129 p 001 substance abuse problems 151 vs 101 p 005 medically complex 531 vs 399 psychosocially complex 449 vs 282 p 001 regression analyses clinics least 30 minority patients likely chaotic work environments odds ratio 40 p 003 fewer physicians reporting high work control 02 p 003 high job satisfaction 04 p 01clinics serving higher proportions minority patients challenging workplace organizational characteristics