People of color and the unemployed — two demographics that arguably face significant financial hardship — travel greater distances and wait longer for health care, an analysis of health care data has shown.
The findings compiled by researchers at the University of Pittsburgh School of Medicine showed that while patients spent an average of 86 minutes at the clinic, disparities existed along race and educational attainment. Hispanic patients spent 25 more minutes in the clinic than their white counterparts. Travel time among black patients was 45 minutes compared to 36 minutes for white people. Among the unemployed, financial barriers and lack of insurance counted as hurdles in accessing timely health care.
The data set used in the study included survey responses of nearly 4,000 adults who reported the time they spent waiting for medical care during their visit to a clinic. Researchers also estimated each patient’s travel time to the hospital and used a separate survey of 150,000 doctor visits in a four-year span to calculate face-to-face time with a physician.
“Unfortunately, there are so many disparities in healthcare access and health outcomes already identified in our healthcare system that I don’t think these results are necessarily surprising,” Dr. Kristin N. Ray of the University of Pittsburgh School of Medicine, who worked on the study, told Reuters Health. “Instead, I think these results add another dimension to the many inequalities in our healthcare system, and document a very real additional burden for patients.”
Beyond wait and travel times, people of color don’t enjoy the same kind of relationship with the medical profession as well-off white patients do.
For example, a study conducted by the Institute of Medicine found that black Americans received less effective care than their white counterparts, socioeconomic and insurance status notwithstanding. Patients of color also received fewer recommended treatments for chronic illness — including HIV/AIDS, cancer, and heart disease. Additionally, it’s not unusual for hospital administrators to reject insurance plans that commonly serve disadvantaged members of ethnic groups.
To explain the origin of longer travel times, experts point to practitioners’ decision to avoid neighborhoods with a high-concentration of non-white residents. People of color, the poor, and the elderly suffer in the process. Longer distances to emergency rooms increase a patient’s likelihood of dying by 5 percent, a study last year found.
Hospitals have tried to solve the issue of patient wait time and other problems plaguing patients of color through open access scheduling, a method that allows patients to receive an appointment slot with their physician on the same day they call. Proponents say it’s effective in managed care and fee-for-service environments. Changes also include the elimination of the overbooking of schedule visits and the introduction of telemedicine and virtual consultation. Even with their potential, Ross told Reuters that “the verdict is still out on what methods will work best.”
Perhaps other forms of intervention are needed in shortening patient wait time and improving the hospital experience. Last year, the American Association of Medical Colleges launched a series of workshops aimed at helping medical professionals become more aware of the implicit bias — attitudes and behavior that adversely affect interactions with patients of color.
Medical school admissions offices are also mulling over how to best attract and retain students from different racial backgrounds. Fewer than 20 percent of doctors identify as black or Latino, racial groups that account for nearly 30 percent of the U.S. population. Doctors of color can bring a new perspective that helps them work in their patients’ best interests. Experts say non-white practitioners often lead more patient-centered conversations, encourage more questions, and offer cultural understanding that leads to better health outcomes for patients of color.
“Physicians of color are also more likely to see patients of color who are in need but no one is speaking for those populations. That’s why we have to increase financial aid and residency positions for students of color,” Walker Keenan, a member of #WhiteCoats4BlackLives, a medical student-run organization that aims to eliminate racial bias in medicine, told ThinkProgress in August. “For us, there’s often a drop off in diversity between medical school and admission of people of color into residency programs.”