A study published today in the Archives of Internal Medicine may shed new light on why minority Americans have poorer health outcomes from chronic conditions such as hypertension, heart disease and diabetes.
Researchers found that clinics serving higher proportions of these minority patients tend to have more challenging work environments and organizational characteristics.
"Unfavorable patient and physician outcomes may be attributable to disparities in work conditions at these clinics," said Anita Varkey, MD, lead author, assistant professor in the department of medicine, Loyola University Chicago Stritch School of Medicine and medical director of general medicine at Loyola Outpatient Center, Loyola University Health System. "When you have limited access to medical supplies, referral specialists, and examination rooms, coupled with a more complex patient mix, you can start to see the challenges involved with providing high quality primary care."
Few studies have examined the influence of physician workplace conditions on health care disparities. This study compared 96 primary care clinics in five regions, including Chicago. Data were collected from 388 primary care physicians and 1,701 adult patients with chronic diseases. Researchers compared 27 clinics (41.8 percent of physicians) that had at least 30 percent minority patients with 69 clinics (45.9 percent of physicians) that had less than 30 percent. The clinics with larger proportions of minority patients were four times more likely to have a chaotic work environment, and their physicians were half as likely to report job satisfaction. These physicians also had a tendency to report higher stress and intention to leave.
"All of these factors can contribute to health care disparities," said Varkey. "Challenges in workplace characteristics exacerbate time pressures already complicated by disadvantaged patients with chronic medical and psychosocial issues."
Patients in clinics with higher proportions of minorities were more frequently depressed (22.8 percent vs. 12.1 percent), more often covered by Medicaid (30.2 percent vs. 11.4 percent), and had lower health literacy (3.7 vs. 4.4, on a scale where one is lowest and five is highest). Physicians from these clinics reported that more of their patients spoke little to no English (27.1 percent vs. 3. 4 percent), had more chronic pain (24.1 percent vs. 12.9 percent), substance abuse problems (15.1 percent vs. 10.1 percent), and complex medical cases.
The authors indicated that strategies to improve patient care for these clinics should go beyond efforts to improve health care coverage and reimbursement. Interventions also should target measures to reduce physician burnout, clinic chaos and work control measures.
"While further research is needed, health care reform strategies should consider the role that work environment plays in quality of care," said Varkey.
Nora Plunkett | EurekAlert!
Study relating to materials testing Detecting damages in non-magnetic steel through magnetism
23.07.2018 | Technische Universität Kaiserslautern
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.
Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...
Scientists have discovered that the electrical resistance of a copper-oxide compound depends on the magnetic field in a very unusual way -- a finding that could help direct the search for materials that can perfectly conduct electricity at room temperatur
What happens when really powerful magnets--capable of producing magnetic fields nearly two million times stronger than Earth's--are applied to materials that...
08.08.2018 | Event News
27.07.2018 | Event News
25.07.2018 | Event News
15.08.2018 | Physics and Astronomy
15.08.2018 | Earth Sciences
15.08.2018 | Physics and Astronomy