Nativity Status and Patient Perceptions of the Patient-Physician Encounter: Results From the Commonwealth Fund 2001 Survey on Disparities in Quality of Health Care

<p> <strong> Background: </strong> Although racial and ethnic differences in healthcare have been extensively documented in the United States, little attention has been paid to the quality of health care for the foreign-born population in the United States.</p><p> <strong> Objectives: </strong> This study examines the association between patient perceptions of the patient-physician interaction and nativity status.</p><p> <strong> Research Design: </strong> Cross-sectional telephone survey.</p><p> <strong> Subjects: </strong> A total of 6674 individuals (US-born &le; 5156; foreign-born &le; 1518) 18 years of age and older.</p><p> <strong> Measures: </strong> Seven questions measuring the quality of patient-physician interactions.</p><p> <strong> Results: </strong> Of the 7 outcome variables examined in the unadjusted logistic regression model, only 2 remained statistically significant in the fully adjusted model. For both the total sample and for Asians only, compared with US-born, foreign-born individuals were at greater odds [total sample, odds ratio (OR) &le; 1.43; 95% confidence interval (CI) &le; 1. 01&gcirc;&euro;"2.04; Asians, OR &le; 3.25; 95% CI &le; 1.18&gcirc;&euro;"8.95] of reporting that their physician did not involve them in their care as much as they would have liked. Compared with US-born Asians, foreign-born Asians were at greater odds of reporting that their physician did not spend as much time with them as they would have liked (OR &le; 4.19; 95% CI &le; 1.68&gcirc;&euro;"10.46).</p><p> <strong> Discussion: </strong> Findings from our study suggest that we should not only track disparities by race and ethnicity but also by nativity status.</p>