The influence of institutional factors on patient–provider communication and interactions in the U.S. healthcare system

Abstract

Communication and interactions between patients and healthcare providers are important components in the provision of healthcare services. In this study, we assessed the effects of institutional factors, defined as a usual source of care and the type of a usual source of care, on perceived patient–provider communication and interactions. We used individual-level data for adults (N = 89,725) from the Medical Expenditure Panel Survey for the years 2001 to 2012 and employed multivariate logistic regressions to assess the relationship between institutional factors and four communication and interaction outcomes: provider listened to patient, provider explained so that patient understood, provider showed respect to patient, and provider spent enough time with patient. Adults who report having a usual source of care have significantly higher odds of reporting positively on their communication and interactions with their healthcare providers in comparison to adults who do not have a usual source of care. We also find that having an individual physician or nurse practitioner as a usual source of care further improves patient–provider communication and interaction in comparison to having an outpatient clinic, a hospital, an emergency department, or any other type of clinic as a usual source of care. Our study shows that having a usual source of care is an important component in patient–provider communication and interactions, beyond patients’ personal characteristics. We also show that having a physician (or any other individual practitioner) rather than a healthcare facility, such as an outpatient clinic, as a usual source of care further improves patient–provider communication and interactions.