Abstract
Background. Effective communication and high trust with doctor are important to reduce the burden of multimorbidity in the rapidly aging population of the US. However, the association of multimorbidity with patient-doctor communication and trust is unknown. Objective. We examined the relationship between multimorbidity and patient-doctor communication and trust among the elderly. Method. We used the Medicare Current Beneficiary Survey (2012) to analyze the association between multimorbidity and patient-doctor communication and trust with multivariable logistic regressions that controlled for patient's sociodemographic characteristics, health status, and satisfaction with care. Results. Most elderly beneficiaries reported effective communication (87.5–97.5%) and high trust (95.4–99.1%) with their doctors. The elderly with chronic physical and mental conditions were less likely than those with only physical conditions to report effective communication with their doctor (Adjusted Odds Ratio [95% Confidence Interval] = 0.80 [0.68, 0.96]). Multimorbidity did not have a significant association with patient-doctor trust. Conclusions. Elderly beneficiaries had high trust in their doctors, which was not affected by the presence of multimorbidity. Elderly individuals who had a mental condition in addition to physical conditions were more likely to report ineffective communication. Programs to improve patient-doctor communication with patients having cooccurring chronic physical and mental health conditions may be needed.
Highlights
Patient-doctor relationship has been defined as a meaningful therapeutic interaction between the patients and their doctors and is considered as the seventh element of healthcare quality [1]
Among 9,867 Medicare beneficiaries included in this study (Table 1), the majority were white (78.5%), lived in a metro region (77.4%), did not have limitations in activities of daily living (66.2%), were either overweight or obese (64.6%), and were satisfied with quality of care (97.4%)
56.6% elderly beneficiaries were women, 57.2% were married, 45.4% had more than high school education, 35.1% were enrolled in HMO, 12.3% had Medicaid insurance, 19.6% had fair or poor general health status, and 58.6% were past or current smokers (Table 1)
Summary
Patient-doctor relationship has been defined as a meaningful therapeutic interaction between the patients and their doctors and is considered as the seventh element of healthcare quality [1]. Among older patients with diabetes, patient-doctor communication was associated with better diabetes self-management [14]. The association of multimorbidity with patient-doctor communication and trust is unknown. We examined the relationship between multimorbidity and patient-doctor communication and trust among the elderly. We used the Medicare Current Beneficiary Survey (2012) to analyze the association between multimorbidity and patient-doctor communication and trust with multivariable logistic regressions that controlled for patient’s sociodemographic characteristics, health status, and satisfaction with care. Most elderly beneficiaries reported effective communication (87.5– 97.5%) and high trust (95.4–99.1%) with their doctors. The elderly with chronic physical and mental conditions were less likely than those with only physical conditions to report effective communication with their doctor (Adjusted Odds Ratio [95% Confidence Interval] = 0.80 [0.68, 0.96]). Programs to improve patient-doctor communication with patients having cooccurring chronic physical and mental health conditions may be needed
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