Table 5.
Distribution of Satisfaction with Medical Care and Health Care-Seeking Behavior of African-American Elders by United States Medical Graduate (USMG) Physicians versus International Medical School Graduate (IMG) Physicians
| African-American Elders with USMG | African-American Elders with IMG | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Elder Responses | 1986 (N=1,478) | 1990 (N=1,003) | 1994 (N=915) | 1998 (N=547) | 1986 (N=157) | 1990 (N=174) | 1994 (N=145) | 1998 (N=87) | p-value*,† |
| Put off care quite often | 154 (10.4) | 66 (6.6) | 35 (3.8) | 16 (2.9) | 14 (8.9) | 17 (9.8) | 5 (3.4) | 2 (2.3) | .703 |
| Reasons for putting off care | |||||||||
| Get better by itself | 348 (23.5) | 111 (12.1) | 74 (13.5) | 33 (21.0) | 15 (10.3) | 11 (12.6) | .391 | ||
| Concern with cost | 301 (20.4) | 73 (8.0) | 30 (5.5) | 35 (22.3) | 11 (7.6) | 7 (8.0) | .185 | ||
| Unsure where to go | 68 (4.6) | 20 (2.2) | 12 (2.2) | 1 (0.6) | 3 (2.1) | 2 (2.3) | NA‡ | ||
| Would do no good | 109 (7.4) | 57 (6.2) | 34 (6.2) | 14 (8.9) | 5 (3.4) | 5 (5.7) | .801 | ||
| Distance or no transportation | 155 (10.5) | 50 (5.5) | 29 (5.3) | 12 (7.6) | 9 (6.2) | 4 (4.6) | .668 | ||
| Any other reason for not going to MD | 157 (10.6) | 33 (3.6) | 25 (4.6) | 14 (8.9) | 6 (4.1) | 5 (5.7) | .924 | ||
| Satisfaction with medical care | 1,286 (87.0) | 858 (85.5) | 737 (80.5) | 432 (79.0) | 131 (83.4) | 146 (83.9) | 129 (89.0) | 60 (69.0) | .331 |
| Perceptions of doctors | |||||||||
| Doctors always do their best to keep patients as old as I am from worrying | 836 (83.3) | 146 (83.9) | .855 | ||||||
| Doctors always treat their patients my age with respect | 896 (89.3) | 152 (87.4) | .441 | ||||||
| Sometimes doctors make patients my age feel foolish | 134 (13.4) | 32 (18.4) | .078 | ||||||
| When treating people about my age doctors always avoid unnecessary patient expenses | 545 (54.3) | 89 (51.1) | .436 | ||||||
| Doctors often cause patients my age to worry a lot, because they do not explain things well | 245 (24.4) | 53 (30.5) | .091 | ||||||
| When treating people about my age doctors respect their patients' feelings | 880 (87.7) | 146 (83.9) | .163 | ||||||
| Doctors never recommend an operation for people my age, unless there is no other way to solve the problem | 712 (71.0) | 100 (57.5) | <.001 | ||||||
| Doctors do not pay enough attention to the health problems that people my age have | 233 (23.2) | 42 (24.1) | .794 | ||||||
| Most of these younger doctors really understand how people my age feel | 514 (51.2) | 97 (55.7) | .273 | ||||||
| Sometimes doctors think that just getting old is a disease that cannot be cured | 400 (39.9) | 77 (44.3) | .278 | ||||||
*
P-values from differences in African-American elder characteristics between categories of USMG and IMG, are obtained fbom Generalized Estimating Equations
†
P-values for satisfaction with care variables in Wave 2 are from χ2 tests for difference in proportions.
‡
P-value indicates there is a differential effect over time (significant interaction of USMG/IMG by time) in which differences in characteristics vary across time, therefore no main effects model can be presented (unsure where to go p =.037)
NA, not applicable.