Perceived discrimination in primary care: Does Payer mix matter?

Area of Science:

• Health Services Research
• Health Disparities
• Patient Experience

Background:

• Limited research exists on how clinic payer mix affects patient perceptions of discrimination.
• Previous studies focused on race and insurance status, not clinic-level insurance composition.

Purpose of the Study:

• To investigate if the payer mix (public vs. private insurance) of primary care clinics influences patient-reported discrimination.
• To identify sociodemographic factors associated with discrimination reports.

Main Methods:

• Anonymous post-clinic visit surveys administered to 3,721 patients from 2015-2017.
• Data collected from seven primary care clinics: three public and four private.
• Logistic regression analyses used to assess discrimination reports.

Main Results:

• Public clinics reported higher rates of race- and insurance-based discrimination than private clinics.
• Multivariate analyses revealed increasing age, Black race, lower education, and Medicaid insurance were linked to higher discrimination odds.
• These sociodemographic associations were observed in both public and private clinic settings.

Conclusions:

• Patient-reported discrimination is more prevalent in public primary care clinics.
• Sociodemographic factors significantly impact perceptions of race and insurance discrimination in primary care.