Lesbian/Gay/Bisexual (LGB) Patient Satisfaction with Health Care Open Access

Messenger-Jones, Elizabeth (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/rf55z783w?locale=en


Lesbian/Gay/Bisexual (LGB) individuals face significant health disparities compared to non-LGB individuals. Lesbians and bisexual women have higher rates of overweight and obesity, have riskier health behaviors and have lower use of preventative services. Further, gay and bisexual men have a higher prevalence of HIV/AIDS and substance use/abuse disorders, as well as higher rates of psychiatric morbidity. Little is known about the patient satisfaction of LGB individuals, a measure that is used as an indicator of health care quality. Studies have shown that higher patient satisfaction is associated with improved health outcomes. To study the patient satisfaction of this population, data from the 2013-2014 National Health Interview Survey (NHIS) was utilized. The study sample included adults age 18-64 who have had health care in the last 12 months. An ordered logistic model controlling for covariates was used to predict patient satisfaction. To test whether geographic region moderated this relationship, an interaction term between LGB status and geographic region was be added to the model. This study hypothesized that LGB individuals would have lower rates of satisfaction compared to heterosexuals. Additionally, based on state policies protecting people based on sexual orientation, the study predicted that LGB individuals living in the Midwest or South would have lower rates of satisfaction with health care compared to those living in the Northeast or West. The study found no difference in satisfaction for LGB individuals and heterosexuals and no difference by region for LGB individuals' patient satisfaction. These results may show a recent improvement in the health care setting, leading to a future reduction health disparities of this group. Results also show a growing acceptance of LGB rights, finding no regional differences in satisfaction among this population. Implications of this study show the importance of current policies and practices that support training health care professionals to treat their LGB patients and that these policies should be enhanced to continue to meet the needs of this population.

Table of Contents

Chapter 1: Introduction 1

Overview 1

Patient Satisfaction of the LGB Population 2

Approach/Rationale 3

Conceptual Framework 3

Research Questions 4

Research Design 4

Study Implications 5

Chapter 2: Literature Review 5

Introduction 5

LGBT Health: A Historical Context 6

LGBT Health Disparities 8

Patient Satisfaction 9

LGB Patient Satisfaction with Health Care: What is Known 11

Geographic Region 14

Summary 15

Chapter 3: Methods 16

Introduction 16

Conceptual Framework 17

Focal Relationship 19

Mechanisms 19

Moderator 20

Description of Confounders and Relationship to the Focal Relationship 21

Testable Hypotheses 23

Dataset 24

Construct Measurement 25

Analytic Strategy 30

Chapter 4: Results 31

Introduction 31

Descriptive Statistics 31

Main Analysis 33

Sub-analyses 37

Geographic Moderator 37

Analyses by Sex 38

Chapter 5: Discussion 41

Summary 42

Strengths and Limitations 46

Implications 48

Recommendations for Future Research 50

Conclusion 52

References 53

Figures and Tables

Figure 1 18

Figure 2 23

Figure 3 23

Table 1 27

Table 2 32

Table 3 34

Table 4 38

Table 5 40

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