ASPPH logo


Member Research & Reports

Member Research & Reports

Maryland Explores Potential of Healthcare Staff Behaviors to Influence Patient Perceptions of Discrimination and Satisfaction

The behaviors of healthcare staff can influence patient perceptions of discrimination and quality of care, according to a study co-authored by Dr. Cheryl L. Holt, associate professor in the Department of Behavioral and Community Health at the University of Maryland School of Public Health, which was published in the American Journal of Public Health.

Existing literature shows a connection between both perceived and overt discrimination and negative health outcomes. Increased attention has been paid to the root factors of health disparities in recent decades, but previous studies have looked only at the patient-physician relationship in determining connections between patients’ health outcomes and their perceptions of how they were treated.

Dr. Holt and fellow researchers from the University of Alabama at Birmingham School of Public Health wanted to examine the role of healthcare staff in forming patients’ perception of discrimination. Researchers interviewed 12 focus groups, stratified by race and gender, of 92 African American and European American participants who had visited a healthcare provider in the previous 12 months. All 92 participants had reported discrimination and dissatisfaction as a result of interactions with non-physician healthcare staff.

During focus-group interviews, both European and African American participants reported feeling discriminated against based on insurance or socioeconomic status and race. European Americans also reported age as a basis of discrimination and poor treatment. Both groups identified communication style, including nonverbal and verbal, as related to the way individuals perceived they were treated.

Participants offered suggestions for ways healthcare staff can better ensure patient satisfaction, including attentiveness, eye contact, smiling, and patience.

Though researchers advise caution in generalizing their findings, which were based on self-reported qualitative data, to different populations, their study presents first-of-its-kind evidence that staff interactions with patients can result in perceived discrimination.

“This is troubling given that perceived discrimination is associated with both negative health outcomes and negative perceptions of quality of care,” the researchers concluded. Interventions to improve these areas of staff and patient interaction could lead to improvements in patient satisfaction.

The article, “We’ll Get to You When We Get to You: Exploring Potential Contributions of Health Care Staff Behaviors to Patient Perceptions of Discrimination and Satisfaction,” was published by the American Journal of Public Health on August 13.