Economically disadvantaged patients may have trouble with patient-provider communication

Patients want their health care providers to listen to them. Critical to the patient-provider interaction is how well providers explain things and how well patients understand their personal health issues. Patients want providers to show them respect during the medical encounter and spend enough time during the visit. Yet certain sociodemographic characteristics may affect whether patients favorably perceive communication with their health care providers, according to a new study. It found, for example, that economically disadvantaged patients may have more difficulty with provider communication.

Jennifer E. DeVoe, M.D., D.Phil., of the Oregon Health & Science University, and colleagues analyzed data from the nationally representative 2002 Medical Expenditure Panel Survey (MEPS) on 16,700 U.S. adults with a health care visit in the past year. They looked at four MEPS items that shed light on how patients felt about their encounters with providers, as well as their demographic and socioeconomic characteristics. Even when controlling for the effects of all demographic and socioeconomic characteristics, consistent predictors of positive perceived communication were older age, having health insurance and a usual source of care, and being Hispanic. The poorest patients were found to be less likely to report that their providers always explained things sufficiently. Patients living in cities also felt that their providers didn't listen to them or spend enough time with them. Men were most likely to report that providers spent enough time during the visit.

The researchers were surprised to find no associations between various communication measures and the level of education attained by patients. They call for future studies to determine how these demographic and socioeconomic differences in perception can be incorporated into pay-for-performance policies. The study was supported by the Agency for Healthcare Research and Quality (HS14645 and HS16181).

See "Measuring patients' perceptions of communication with healthcare providers: Do differences in demographic and socioeconomic characteristics matter?," by Dr. DeVoe, Lorraine S. Wallace, Ph.D., and George E. Fryer Jr., Ph.D., in Health Expectations 12, pp. 70-80, 2009.

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