By Michael Conlon

CHICAGO, Feb 9 (Reuters) - Clinics serving high numbers of minority patients are often chaotic and crowded, contributing to the well-documented disparity in health care between blacks and others, U.S. researchers reported on Monday.

A combination of "time pressure, insufficient resources and patients with complex problems likely constitutes a 'perfect storm' that contributes to the challenges that physicians face in providing quality care to large proportions of minority patients," said Dr. Anita Varkey and colleagues at Loyola University Medical Center, Maywood, Illinois.

Varkey said the study did not turn up a root cause of the problem, although geography and funding cannot be ruled out.

"We can say that the challenges are measurably different from clinics serving lower proportions of minority patients," she said in a telephone interview.

"Physicians from clinics that serve larger proportions of minority patients reported more clinic chaos. The perception of chaos may be exacerbated by low levels of work control, high time pressure and complicated patients."

The doctors in the study were treating patients with three chronic problems -- high blood pressure, diabetes and congestive heart failure.

The researchers compared data on clinics with a third or more of minority patients to others with fewer than a third. The 96 clinics were in New York City and in the upper Midwest.

Those with higher numbers of minority patients had a harder time getting medical supplies, referrals to specialists, pharmacy services and had less space for examinations, the report said.

The doctors in the stressful situations also reported higher proportions of patients who were "difficult to serve -- non-English speaking and medically and psychosocially complex," the researchers wrote in the Archives of Internal Medicine.

Attempts to correct health care disparities on a national basis should consider the work environment as a potential target for change to "reduce physician burnout, increase work control and reduce clinic chaos," the researchers concluded.

"These interventions may include better reimbursement for primary care and more widely available health insurance," they added. (Reporting by Michael Conlon; Editing by Maggie Fox and David Wiessler)

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