Nativity status and patient perceptions of the patient-physician encounter - Results from the Commonwealth Fund 2001 Survey on Disparities in Quality of Health Care

Background: Although racial and ethnic differences in healthcare have been extensively documented in the United States, little attention has been paid to the quality of health care for the foreign-born population in the United States. Objectives: This study examines the association between patient perceptions of the patient-physician interaction and nativity status. Research Design: Cross-sectional telephone survey. Subjects: A total of 6674 individuals (US-born = 5156; foreign-born = 1518) 18 years of age and older. Measures: Seven questions measuring the quality of patient-physician interactions. Results: Of the 7 outcome variables examined in the unadjusted logistic regression model, only 2 remained statistically significant in the fully adjusted model. For both the total sample and for Asians only, compared with US-born, foreign-born individuals were at greater odds [total sample, odds ratio (OR) = 1.43; 95% confidence interval (CI) = 1.01-2.04; Asians, OR = 3.25; 95% CI = 1.18-8.951 of reporting that their physician did not involve them in their care as much as they would have liked. Compared with US-born Asians, foreign-born Asians were at greater odds of reporting that their physician did not spend as much time with them as they would have liked (OR = 4.19; 95% Cl = 1.68-10.46). Discussion: Findings from our study suggest that we should not only track disparities by race and ethnicity but also by nativity status.