MHQP’s Statewide Survey Shows Patients Continue to Experience Racial and Ethnic Disparities in Massachusetts
(February 2024)
Black and Asian patients reported worse experiences in primary care than White patients across many categories in MHQP’s 2023 statewide Patient Experience Survey, the results of which were released today. The same was true of Hispanic/Latino patients when compared to non-Hispanic/Latino patients.
Evidence has shown that positive patient experiences are associated with better health outcomes. A recent survey revealed that health care workers across all races, ethnicities, ages, genders, and care settings, personally witnessed discrimination against patients and consider it to be a serious problem. A deep understanding of how patients experience health care along racial and ethnic lines is, therefore, an essential foundation for addressing disparities across all areas of health care delivery.
To help gain this understanding, MHQP has launched Measured Equity, a multistakeholder initiative to create a comprehensive statewide system to consistently measure racial and ethnic disparities in patient experiences, leveraging MHQP’s statewide survey as a platform. As part of that effort, MHQP also recently announced that we have received a grant from the Robert Wood Johnson Foundation’s Evidence for Action program to explore social risk adjustment methods that will ensure fair comparisons of racial and ethnic disparities in patient experiences across organizations serving different patient populations. This will allow MHQP to engage with participating organizations to make valid comparisons across organizations, better understand the drivers of disparities, and take effective action to address these issues.
First conducted in 2005, MHQP’s survey is the only statewide survey of its kind. Unlike satisfaction surveys that ask about general perceptions, it asks people what actually happened when they or their children received primary care. Results were collected from 444 adult and pediatric primary care practices across the state, representing over 3,300 primary care providers. MHQP revised the commercial survey in 2023 to capture a range of demographic and social determinants of health data to facilitate the stratification of the data by race and ethnicity and enhance our ability to better understand disparities in care. We are gratified that the Massachusetts Medical Society expressed its appreciation that MHQP’s survey “brings forth data and invaluable patient perspectives that reflect concerning, longstanding, issues rooted in racism and systemic barriers…(and) can help inform investment and quality improvement efforts aimed at improving health equity and redressing historical disparities in patient experience and related poor outcomes.”
As the following tables reveal, in all cases where there are statistically significant differences, these differences reflect lower scores for Black and Asian patients as compared to White patients and lower scores for Hispanic/Latino patients as compared to non-Hispanic/Latino patients. Statistically significant differences are noted below in red.
Black Patients Compared to White Patients:
| ADULTS: | CHILDREN: | |||||
|---|---|---|---|---|---|---|
| Composite/Category | White Score | Black Score | Diff | White Score | Black Score | Diff |
| Patient-Provider Communications | 96.3 | 96.3 | 0 | 98.5 | 96.8 | (1.7) |
| Coordinating Patient Care | 90.0 | 86.1 | (3.9) | 88.0 | 87.1 | (0.9) |
| How Well Providers Know Their Patients | 91.4 | 91.0 | (0.4) | 94.2 | 92.7 | (1.5) |
| Assessment of Patient Behavioral Health | 75.3 | 68.4 | (6.9) | N/A | N/A | N/A |
| Ease of Access to Care | 82.7 | 82.7 | 0 | 90.5 | 88.5 | (2.0) |
| Office Staff Professional Excellence | 94.5 | 94.9 | 0.4 | 95.8 | 96.1 | 0.3 |
| Self-Management Support | 66.7 | 66.8 | 0.1 | 53.6 | 55.1 | 1.5 |
| Willingness to Recommend | 92.4 | 92.4 | 0 | 96.6 | 94.6 | (2.0) |
| Patients’ Trust in Their Providers | 87.7 | 85.1 | (2.6) | 92.9 | 87.5 | (5.4) |
| Pediatric Preventive Care | N/A | N/A | N/A | 67.3 | 64.4 | (2.9) |
| Assessment of Child Development | N/A | N/A | N/A | 78.1 | 75.4 | (2.7) |
Asian Patients Compared to White Patients:
| ADULTS: | CHILDREN: | |||||
|---|---|---|---|---|---|---|
| Composite/Category | White Score | Asian Score | Diff | White Score | Asian Score | Diff |
| Patient-Provider Communications | 96.3 | 95.3 | (1.0) | 98.5 | 97.7 | (0.8) |
| Coordinating Patient Care | 90.0 | 86.9 | (3.1) | 88.0 | 85.4 | (2.6) |
| How Well Providers Know Their Patients | 91.4 | 89.1 | (2.3) | 94.2 | 92.5 | (1.7) |
| Assessment of Patient Behavioral Health | 75.3 | 65.6 | (9.7) | N/A | N/A | N/A |
| Ease of Access to Care | 82.7 | 75.6 | (7.1) | 90.5 | 87.3 | (3.2) |
| Office Staff Professional Excellence | 94.5 | 91.0 | (3.5) | 95.8 | 95.3 | (0.5) |
| Self-Management Support | 66.7 | 57.7 | (9.0) | 53.6 | 51.5 | (2.1) |
| Willingness to Recommend | 92.4 | 88.7 | (3.7) | 96.6 | 94.8 | (1.8) |
| Patients’ Trust in Their Providers | 87.7 | 82.4 | (5.3) | 92.9 | 87.3 | (5.6) |
| Pediatric Preventive Care | N/A | N/A | N/A | 67.3 | 64.7 | (2.6) |
| Assessment of Child Development | N/A | N/A | N/A | 78.1 | 75.5 | (2.6) |
Hispanic/Latino Patients Compared to Non-Hispanic/Latino Patients:
| ADULTS: | CHILDREN: | |||||
|---|---|---|---|---|---|---|
| Composite/Category | Non-Hispanic/Latino Score | Hispanic/Latino Score | Diff | Non-Hispanic/Latino Score | Hispanic/Latino Score | Diff |
| Patient-Provider Communications | 96.2 | 95.2 | (1.0) | 98.3 | 97.3 | (1.0) |
| Coordinating Patient Care | 89.6 | 87.6 | (2.0) | 88.0 | 84.3 | (3.7) |
| How Well Providers Know Their Patients | 91.3 | 90.2 | (1.1) | 94.0 | 92.3 | (1.7) |
| Assessment of Patient Behavioral Health | 74.3 | 71.8 | (2.5) | N/A | N/A | N/A |
| Ease of Access to Care | 82.4 | 79.9 | (2.5) | 90.2 | 88.4 | (1.8) |
| Office Staff Professional Excellence | 94.3 | 93.9 | (0.4) | 95.8 | 95.2 | (0.6) |
| Self-Management Support | 66.2 | 65.9 | (0.3) | 53.6 | 50.5 | (3.1) |
| Willingness to Recommend | 92.1 | 90.8 | (1.3) | 96.4 | 93.9 | (2.5) |
| Patients’ Trust in Their Providers | 87.3 | 84.6 | (2.7) | 92.2 | 89.2 | (3.0) |
| Pediatric Preventive Care | N/A | N/A | N/A | 67.1 | 62.6 | (4.5) |
| Assessment of Child Development | N/A | N/A | N/A | 77.7 | 75.4 | (2.3) |
“It is appalling that there are differences in patient experiences across racial and ethnic groups in Massachusetts,” said Barbra Rabson, MHQP’s President and CEO. “MHQP’s mission is to improve patient experiences of care in Massachusetts, and we need to do this for all of our patients.”
“By leveraging the shared measurement system MHQP already has in place, we can identify systemic issues that lead to these disparities,” said Julita Mir, MD, MHQP’s new Board Chair. “Then we can begin to look at best practices to drive improvements across organizations, not just organization by organization.”