Outcomes/Effectiveness Research

Nonelderly patients have more negative perceptions of patient-provider communication than the elderly

Effective communication between health care providers and patients can substantially influence patient behaviors and health outcomes. Nonelderly patients have more negative perceptions of this communication than the elderly, according to a new study. Researchers found that individuals aged 18 to 64 years were less likely than those 65 and older to report that their provider always listened to them, always showed respect for what they had to say, and always spent enough time with them. Patients aged 25 to 44 years were similarly less likely to report positive perceptions of communication with their provider, although the perceptions of those between 45 and 64 years were somewhat closer to the oldest group. Patient age was less associated with perceptions about how usual care providers engaged patients in shared health care decisionmaking.

Adults between 18 and 44 years were less likely to report that their usual care provider(s) included them in health care decisionmaking compared with the oldest group. However, there was no significant difference in this area between the oldest group and those 45 to 64 years. There were no significant differences among the various age groups in their responses to the question of how often a usual care provider gave them some control over treatment. It's not clear whether younger patients have higher expectations for communication, whether age itself influences how different patients perceive similar interactions, or if physicians simply communicate differently with older patients, notes Jennifer E. DeVoe, M.D., D.Phil., of the Oregon Health and Science University.

Dr. DeVoe and fellow researchers analyzed data from the 2002 Medical Expenditure Panel Survey. They examined the association between patient age and six outcomes related to communication and decisionmaking autonomy. They controlled for other factors affecting patient-provider communication such as gender, race/ethnicity, family income, and education. The study was supported in part by the Agency for Healthcare Research and Quality (HS14645 and HS16181). See "Patient age influences perceptions about health care communication," by Dr. DeVoe, Lorraine S. Wallace, Ph.D., and George E. Fryer, Jr., Ph.D., in the February 2009 Family Medicine 41(2), pp. 126-133.

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