The purpose of this study is attempting to identify factors in relation to perceived cultural competent care in relation to quality of care that may reduce health disparity.

Background and Significance:

Reducing health disparity is one of the goals established by Healthy People 2010, a report identifying disease prevention and promotion objectives for the nation to achieve during the first decade of this century(1). Numerous efforts have been undertaken to reduce health disparities based on race and ethnicity, including policy change, provider training and recruitment of minority providers, and establishment of guidelines and standards for providing culturally and linguistically appropriate services (2-4). However, disparity continues to be a concern in both health and mental health care. Individuals with mental illness are also having high comorbid physical conditions. Unfortunately, this population are more likely to not receive care or receive poor quality of care (5-8).

Design

A population based mail survey was used to collect data from 488 adult Medicaid recipients with diverse race-ethnicities. All subjects have been diagnosed with diabetes with or without mental illness. Data collected include demographic information and linguistic capability, health/mental health conditions, mental and physical care services received, perceived competent services, trust relationship with providers and provider characteristics. Regression model is used to identify factors related to quality of care and disparity in services received.

Results, Conclusions and Implication:

The results indicated that an individual's level of trust is the only significant factor related to perceived culturally competent care. Additionally, while including perceived culturally competent care, trust relationship and mental health functioning level are the two factors that are significantly related to perceived overall quality of care. These findings have significant implication for health administrators, clinicians as well as health educators in terms of how to assist clinician build a trust relationship with their patients.