Lesbian/Gay/Bisexual (LGB) Patient Satisfaction with Health Care Open Access
Messenger-Jones, Elizabeth (2016)
Abstract
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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