Evidence map›Paper›PMID 15836534›Full record

ArticleJournal of general internal medicine2005

Racial and ethnic disparities in access to physicians with HIV-related expertise.

Kevin C Heslin, Ronald M Andersen, Susan L Ettner, William E Cunningham

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Journal of general internal medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.9field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 34 citations in OpenAlex.

  1. Observational
  2. Differences in ambulatory care fragmentation by race.BMC health services research · 2021
    Article
  3. Viral Pandemics of the Last Four Decades: Pathophysiology, Health Impacts and Perspectives.International journal of environmental research and public health · 2020
    Review
  4. Article
  5. Article
  6. Article
  7. Liver transplantation trends in the HIV population.Digestive diseases and sciences · 2011
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Kevin C HeslinResearch Center in Minority Institutions, Charles R. Drew University of Medicine and Science, Lynwood, CA 90262, USA. keheslin@cdrewu.edu
Ronald M Andersen
Susan L Ettner
William E Cunningham
University of California, Los Angeles · USCharles R. Drew University of Medicine and Science · US

Funding

RESEARCH INFORMATICS COREG12RR003026 · NCRR · CHARLES R. DREW UNIVERSITY OF MED &SCI · PI BAKER, RICHARD S. · 1986 to 2004
$11.5M
DREW/UCLA Project Export CenterP20MD000148 · NIMHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SHAPIRO, MARTIN F · 2002 to 2006
$3.6M
HIV COST AND SERVICES UTILIZATION STUDY (HCSUS)U01HS008578 · AHRQ · RAND CORPORATION · PI SHAPIRO, MARTIN F · 1994 to 1999
–
AHRQ HHS U01 HS008578AHRQ HHS U-01HS08578NCRR NIH HHS G12 RR003026NCRR NIH HHS G12-RR03026-15NIMHD NIH HHS 1 P20MD00148-01NIMHD NIH HHS P20 MD000148Wellcome Trust
6 · The paper itself

Abstract

objectiveProfessional medical associations recommend that physicians who treat patients with human immunodeficiency virus (HIV) have a measurable form of disease-specific expertise, such as high HIV patient volume or infectious diseases certification. Although it is known that racial/ethnic minorities generally have worse access to care than do whites, previous work has not examined disparities in the use of physicians with HIV-related expertise. DESIGN, SETTING, AND

participantsWe linked data from a prospective cohort study of 2,207 persons with HIV receiving care in the United States with a cross-sectional survey of 404 physicians caring for them. Using multivariate analysis, we estimated the association of patient race/ethnicity with the experience and training of their physicians, controlling for health status, socioeconomic status, demographic characteristics, and geographic variation in provider supply.

resultsCompared with white patients, African Americans were less likely to have an infectious diseases specialist as a regular source of care (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.37 to 0.95). Persons of Alaskan Native, American Indian, Asian, Pacific Islander, or mixed racial background were also less likely than whites to have an infectious diseases specialist (OR, 0.44; 95% CI, 0.23 to 0.83). Conversely, Latino patients had physicians whose HIV patient volume was, on average, 24% higher than the physicians of white patients (incident rate ratio, 1.24; 95% CI, 1.03 to 1.50).

conclusionsSome groups of racial/ethnic minorities are less likely than are whites to have infectious diseases specialists as a regular source of care. The finding that the physicians of Latino patients had relatively higher HIV caseloads suggests that this particular patient subpopulation has access to HIV expertise. Further work to explain racial/ethnic differences in access to physicians will help in the design of programs and policies to eliminate them.

Indexed as

Clinical CompetenceBlack or African AmericanCross-Sectional StudiesFemaleHealth Care SurveysHealth Services AccessibilityHispanic or LatinoHIV InfectionsHumansLogistic ModelsMaleMinority GroupsMultivariate AnalysisRegression AnalysisUnited StatesWhite People

Identifiers

PMID15836534
PMCPMC1490084
OpenAlexW1494387010

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.