Table 6.
Distribution of Satisfaction with Medical Care and Health Care-Seeking Behavior of White Elders by United States Medical Graduate (USMG) Physicians versus International Medical School Graduate (IMG) Physicians
| White Elders with USMG | White Elders with IMG | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Elder Responses | 1986 (N=1,480) | 1990 (N=1,094) | 1994 (N=897) | 1998 (N=543) | 1986 (N=135) | 1990 (N=129) | 1994 (N=77) | 1998 (N=45) | p-value*,† |
| Put off care quite often | 182 (12.3) | 91 (8.3) | 44 (4.9) | 17 (3.1) | 16 (11.9) | 16 (12.4) | 7 (9.1) | 5 (11.1) | NA‡ |
| Reasons for putting off care | |||||||||
| Get better by itself | 446 (30.1) | 125 (13.9) | 76 (14.0) | 41 (30.4) | 22 (28.6) | 7 (15.6) | .165 | ||
| Concern with cost | 275 (18.6) | 62 (6.9) | 26 (4.8) | 27 (20.0) | 12 (15.6) | 5 (11.1) | .129 | ||
| Unsure where to go | 57 (3.9) | 16 (1.8) | 9 (1.7) | 7 (5.2) | 3 (3.9) | 4 (8.9) | .040 | ||
| Would do no good | 202 (13.6) | 62 (6.9) | 44 (8.1) | 16 (11.9) | 8 (10.4) | 3 (6.7) | .380 | ||
| Distance or no transportation | 93 (6.3) | 25 (2.8) | 24 (4.4) | 12 (8.9) | 4(5.2) | 2 (4.4) | .310 | ||
| Any other reason for not going to MD | 150 (10.1) | 38 (4.2) | 25 (4.6) | 13 (9.6) | 5 (6.5) | 4 (8.9) | .902 | ||
| Satisfaction with medical care | 1,302 (88.0) | 959 (87.7) | 773 (86.2) | 446 (82.1) | 112 (83.0) | 104 (80.6) | 67 (87.0) | 34 (75.6) | .011 |
| Perceptions of doctors | |||||||||
| Doctors always do their best to keep patients as old as I am from worrying | 899 (82.2) | 104 (80.6) | .664 | ||||||
| Doctors always treat their patients my age with respect | 977 (89.3) | 111 (86.0) | .264 | ||||||
| Sometimes doctors make patients my age feel foolish | 133 (12.2) | 13 (10.1) | .491 | ||||||
| When treating people about my age doctors always avoid unnecessary patient expenses | 556 (50.8) | 52 (40.3) | .024 | ||||||
| Doctors often cause patients my age to worry a lot, because they do not explain things well | 232 (21.2) | 25 (19.4) | .630 | ||||||
| When treating people about my age doctors respect their patients' feelings | 970 (88.7) | 109 (84.5) | .165 | ||||||
| Doctors never recommend an operation for people my age, unless there is no other way to solve the pboblem | 781 (71.4) | 88 (68.2) | .452 | ||||||
| Doctors do not pay enough attention to the health problems that people my age have | 200 (18.3) | 28 (21.7) | .345 | ||||||
| Most of these younger doctors really understand how people my age feel | 485 (44.3) | 65 (50.4) | .191 | ||||||
| Sometimes doctors think that just getting old is a disease that cannot be cured | 346 (31.6) | 49 (38.0) | .144 | ||||||
*
P-values from differences in white elder characteristics between categories of USMG and IMG are obtained from 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 (put off care p =.045)
NA, not applicable.