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Vulnerability and the patient-practitioner relationship: The roles of gatekeeping and primary care performance

Author

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  • Shi, L.
  • Forrest, C.B.
  • Von Schrader, S.
  • Ng, J.

Abstract

Objectives. We examined whether patients' perceptions of their relationships with primary care practitioners (PCPs) vary by vulnerability status and assessed the extent to which gatekeeping arrangements and primary care performance moderate potential disparities. Methods: We used the nationally representative 1996-1997 Community Tracking Study Household Survey as our data source. Results. Whites reported better patient-practitioner relationships than minorities. Requirements that patients select a PCP and obtain referral authorization neither reduced nor exacerbated racial disparities in the patient-practitioner relationship. On the other hand, access to and continuity with a PCP substantively reduced disparities, especially for the most vulnerable group. Conclusions. Enhancing primary care performance may reduce some of the barriers to care experienced by vulnerable populations, thereby improving patients' relationships with their PCPs.

Suggested Citation

  • Shi, L. & Forrest, C.B. & Von Schrader, S. & Ng, J., 2003. "Vulnerability and the patient-practitioner relationship: The roles of gatekeeping and primary care performance," American Journal of Public Health, American Public Health Association, vol. 93(1), pages 138-144.
    • Handle: RePEc:aph:ajpbhl:2003:93:1:138-144_5
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    Cited by:

    1. Grant H Skrepnek & Joseph L Mills Sr & David G Armstrong, 2015. "A Diabetic Emergency One Million Feet Long: Disparities and Burdens of Illness among Diabetic Foot Ulcer Cases within Emergency Departments in the United States, 2006–2010," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-15, August.
    2. Michaela Olm & Ewan Donnachie & Martin Tauscher & Roman Gerlach & Klaus Linde & Werner Maier & Lars Schwettmann & Antonius Schneider, 2021. "Ambulatory specialist costs and morbidity of coordinated and uncoordinated patients before and after abolition of copayment: A cohort analysis," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-14, June.

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