Healthcare Disparities: Will the doctor see you now? (HEALTHCARE ACCESS RSRCH)

Instructor Name: 
Dr. Rajiv Sharma
Course Description: 

Students will contribute to an ongoing research project on access to healthcare. Participants will have an opportunity to reflect on their own experience with the healthcare system as well as collect, analyze and disseminate information on access to primary care in the US. No prior research experience required. Results will be presented to Kaiser Permanente Center for Health Research.

Portland State University has the only group in the US that conducts a national longitudinal audit of primary care physicians offices based on race/ethnicity, sex and insurance type of simulated patients.

Primary care has been identified as a key component of the US healthcare system because of its ability to deliver improved health at a reasonable cost. However, disparities in access to primary care based on race/ethnicity and insurance type, among other characteristics of patients, are well documented. Furthermore, the climate for primary care is evolving rapidly since the Affordable Care Act, also called Obamacare, is threatened with repeal early in 2017.

Students enrolled in the capstone will spend the first 3 weeks of class conducting a mini audit of primary care offices. They will be trained to call on behalf of simulated patients (a purported aunt or uncle) requesting a new patient physical exam. Calling on behalf of a purported aunt or uncle enables the students to represent prospective patients from all groups, and provides a degree of separation for the students.

Data collected includes: appointment availability, wait to appointment, offer of alternative provider, length of appointment, among other variables. Analysis of the data will enable students to reflect on challenges faced by different populations as they seek to access primary care services. Data from this project will be disseminated by the students at the local and national level and may be able to provide timely information on changes in the primary care environment during a tumultuous period in the healthcare system. The validity of the data will depend on the number of offices contacted by the students, among other considerations. It is unlikely that the students will be able to generate sufficient high quality data in one term to be publishable in a refereed journal.

Project Description: 

This capstone will have two final projects. The first is the creation of a working paper that incorporates the analysis conducted on data the students collect at the beginning of the term, as well as a literature review in the area of health care disparities. The second is a final presentation to Kaiser Permanente's Center for Health Research.