A systematic search and review of the discrimination in health care measure, and its adaptations.
Sheryl Thorburn, Olivia J Lindly
PMID 34688522WHAT IT FOUND
A seven-item patient-reported measure of discrimination in health care was used in 22 mostly cross-sectional studies, mostly for race or ethnicity.
Across studies, patients who reported discrimination also reported poor communication, access problems, lower satisfaction, and adherence issues.
Key findings
01Twenty-two articles using or adapting the Discrimination in Health Care Measure were included after screening.
02Nineteen studies measured discrimination based on race, ancestry, national origin, color, or ethnicity, and many included studies were cross-sectional with small samples.
03Fifteen articles reported multivariable analyses, and discrimination based on race or ethnicity was significantly associated with poor patient-provider communication, problems accessing needed health care, lack of preventive care receipt, low treatment adherence, higher hemoglobin A1C levels, and lower health care satisfaction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were mostly cross-sectional, small, and used non-probability sampling, so they describe links at one time point rather than cause. The review may have missed studies because of its citation-based search, database limits, timeframe, and focus on published articles. Publication bias may have excluded studies with low reliability or non-significant findings. Many articles did not report the full wording of the measure or its psychometric properties. Most psychometric reporting was limited to Cronbach's alpha, and only one study reported construct validity analyses. The measure was usually used for general health care discrimination, not for specific settings or provider groups.
Declared interests
No conflicts-of-interest declaration is included in the supplied text. The provided publication types list research support from NIH extramural and U.S. government Public Health Service sources.
The easy way to misread this
Do not read the reported links as proof that discrimination in health care caused poor communication, access problems, or adherence issues. The included studies were mostly cross-sectional, and this review evaluated a measure, not an intervention.