Twenty-seven relevant studies were identified (n=56,276 patients and 1,756 providers): 15 retrospective studies or that employed a secondary analysis (n=46,936, range 116 to 13,681); four qualitative studies (n=234, range 10 to 137); three cross-sectional surveys (n=16,056, range 358 to 13,882); one study that collected data from actual patient-provider interactions (n=389); one prospective study (n=252); and three experimental studies (n=1,229, range 120 to 981).
Patient-provider race-concordance was associated with positive health outcomes for minorities in nine studies, no association in eight studies and mixed findings in 10 studies.
Positive health outcomes identified were: timely receipt of treatment (one study); provision of more aggressive treatment (one study); greater use of medical services (one study) and preventive care (two studies); improved communication and participatory decision making (two studies); and preference for (one study) and greater satisfaction with (three studies) provider and healthcare.
Limitations described for the nine studies with positive outcomes were: data based on patient self-report (six studies); small physician sample (or minority physician sample) (five studies); small patient sample (two studies); possible data errors (two studies); limited statistical power (one study); unrealistic service pattern (one study); and no correction for confounders (one study).
When studies were grouped according to race-concordance outcome, numbers of studies with positive findings were: two of eight studies for provision of healthcare: two of seven studies for utilisation of healthcare and three studies with mixed findings; two of five studies of patient-provider communication and two studies with mixed findings; three of five studies of patient satisfaction with provider of same race and one study with mixed findings; one of four studies of patient preference for provider of same race and the other studies with mixed results; and one of three studies of perception of respect in race-concordant relationships and the other studies with mixed results.
Factors other than race-concordance in the included studies that appeared to be more important predictors of patient outcomes were reported. Details of studies where race-concordance was associated with worse outcomes for minorities were given.