According to a survey published online in BMJ Quality & Safety, minority ethnic patients are unsatisfied with NHS primary care services, irrespective of the fact that they are using a national healthcare system that is supposed to be providing universal coverage.
More and more patient experience surveys are used to evaluate the quality of primary and hospital care alongside evaluations of clinical outcomes. A clinical quality measure revealed consistent discrepancies in how patients evaluate their care; patients from different socio-economic backgrounds, younger patients, those from ethnic backgrounds, wealthier patients, and those regarding themselves to be of ‘poor-health’ generally report less positive experiences of the health services they received.
Researchers wanted to establish the reasons for this and examined data from the 2009 English General Practice Patient Survey, consisting of more than 2 million respondents from 8,000 general practices across the country.
Focusing on 11 types of various patient experiences including communication with doctors and nurses, access to and continuity of care, and overall satisfaction with care, the authors found rather large and significant differences in the average scores for all types of patient experiences among patients of different ages, health status, and ethnicities.
In contrast, differences between male and female experiences as well as those between the wealthy and the poor were relatively small.
Older patients reported a much higher level of satisfaction of care compared with younger patients, with a difference of up to 16 points on a 100-point scale.
Bangladeshi, Pakistani, Indian, and Chinese patients reported remarkably lower scores regarding their experiences of professional communication compared with white British patients, with between 6 to 9 points difference on the scale, while black patients reported experiences similar to those of white British patients.
The authors highlight the fact that patients from these ethnic backgrounds seemed to be clustered in generally low performing practices (according to measures of patient satisfaction) accounted for half of this difference for South Asian patients and for 14% of that for Chinese patients.
They say:
“If the overall performance of low performing practices were improved, as is the goal of a series of major UK government policy initiatives, this would also help improve the patient experiences of South Asian and Chinese patients.”
Clustering does however not explain the wide satisfaction discrepancies between ethnic and white British patients of differing ages and self-reported health status within the same poorly performing practice nor does it indicate why in some practices, Chinese and South Asian patients rated their care ‘the same’ or ‘better’ than white British patients.
The authors conclude that discrepancies in care provision may therefore at least partly explain some of these ethnic differences.
Written by Petra Rattue