This paper critically examines criteria for equitable, effective, and efficient health care and explores theoretical propositions about how these three components of health care affect health outcomes and patient satisfaction. Findings from four studies with older, low-income immigrants and minorities, including Chinese and Russian immigrants, U.S.-born African Americans, and a non-immigrant, non-minority comparison group of Caucasians are presented. Critical analyses suggest that (a) equity, effectiveness, and efficiency must operate as a triad to improve health outcomes, and (b) patient satisfaction is not necessarily related to effectiveness and efficiency. This article is an adapted version of a keynote address at the 12th Annual Primary Care for the Underserved Conference held May 2004 in Fort Lauderdale, FL.

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Russia patient care China psychological aspect Caucasian Russian Federation minority group human statistics ethnology African American Outcome and Process Assessment (Health Care) United States Humans Treatment Outcome Community Health Nursing health services research Asian Americans Minority Groups Asian American cultural factor patient satisfaction patient education Article migration European Continental Ancestry Group standard Emigration and Immigration Cultural Characteristics attitude to health African Americans Patient Care Team Health Services Accessibility primary health care health care delivery