Perceived discrimination in medical settings and perceived quality of care: A population-based study in Chicago

Perceived discrimination in medical settings remains prevalent within the U.S. health care system. However, the details of these experiences and their associations with perceived quality of care are not well understood. Our study assessed multiple measures of perceived racial/ethnic discrimination in medical settings and investigated the locations and purported perpetrators of the discriminatory experiences within a population-based sample of 1,543 Black, White, Mexican, Puerto Rican, and Other adults. We used logistic regression to estimate associations between perceived discrimination in the medical setting and three quality of care indicators. Overall, 40% of the sample reported one or more types of perceived discrimination in a medical setting, with significant differences by race/ethnicity. Discrimination was perceived across health settings and from a variety of providers and staff. In adjusted logistic regression models, individuals reporting discrimination had more than twice the odds of reporting fair or poor quality of care (OR = 2.4 [95% CI: 1.4-4.3]). In addition, perceived discrimination in medical settings was significantly associated with report of not having enough time with the physician and not being as involved in decision-making as desired. These findings expand our understanding of perceived discriminatory experiences in health care and the consequences of it for patients, providers, and health care systems. This information is essential for identifying future provider interventions and improving the training of health care professionals.