Quality Of Provider Communication Research Articles

Health Care Use, Coverage, and Experiences During the Year Prior to Pregnancy in a Primarily Hispanic Population with Low Income: A Descriptive Qualitative Study.

A qualitative picture of the health care experiences prior to pregnancy can inform patient-centered strategies to optimize preconception health. This study describes health care utilization and experiences and how health care costs were covered in the year prior to pregnancy in a population of primarily Hispanic women with low income. Pregnant participants were recruited from 5 Federally Qualified Health Center clinics. Semistructured interviews included questions about health care in the year prior to pregnancy. Transcripts were analyzed using a thematic approach that integrated deductive and inductive analysis. Most participants self-identified as Hispanic. Just under half were US citizens. All but one were Medicaid or Children's Health Insurance Program Perinatal coverage insurance during pregnancy and relied on a variety of strategies to cover prepregnancy health care costs. Almost all received health care during the year prior to pregnancy. Fewer than half reported an annual preventive visit. Health care needs that led to care-seeking included a prior pregnancy, chronic depression, contraception, workplace injury, a persistent rash, screening and treatment for sexually transmitted infection, breast pain, stomach pain (leading to gallbladder removal), and kidney infection. The ways in which study participants covered the costs of health care ranged in terms of sources and complexity. Although some participants described stable health care coverage, most reported changes throughout the year as they pieced together various health care coverage programs and out-of-pocket payments. When participants did seek health care prior to their current pregnancy, most described the experience in positive terms and focused on health care provider communication quality. Respect of patient autonomy was highly valued. Women with pregnancy-related health care coverage accessed care for a wide range of health care needs prior to pregnancy. Health care providers may consider strategies to respectfully introduce preconception care into any visit by an individual who could become pregnant.

Migrant and native women’s perceptions of prenatal care communication quality: the role of host-country language proficiency

BackgroundDespite the potentially significant impact of women-prenatal care provider communication quality (WPCQ) on women’s perinatal health, evidence on the determinants of those perceptions is still lacking, particularly among migrant women.MethodsWe aimed to examine the effect of women’s host-country language proficiency on their perceived WPCQ. We analyzed the data of 1210 migrant and 1400 native women who gave birth at Portuguese public hospitals between 2017 and 2019 and participated in the baMBINO cohort study. Migrants’ language proficiency was self-rated. Perceived WPCQ was measured as a composite score of 9 different aspects of self-reported communication quality and ranged from 0 (optimal) to 27.ResultsA high percentage of women (29%) rated communication quality as “optimal”. Zero-inflated regression models were fitted to estimate the association between language proficiency and perceived WPCQ. Women with full (aIRR 1.35; 95% CI 1.22,1.50), intermediate (aIRR 1.41; 95% CI 1.23,1.61), and limited (aIRR 1.72; 95% CI 1.45,2.05) language proficiencies were increasingly more likely to have lower WPCQ when compared to natives.ConclusionsFacilitating communication with migrant women experiencing language barriers in prenatal care could provide an important contribution to improving prenatal care quality and addressing potential subsequent disparities in perinatal health outcomes.

PD33-12 EVALUATION OF THE CHARACTERISTICS AND URGENCY OF HOME-CALL PAGER COMMUNICATIONS AND UROLOGY TRAINEE-PERCEPTION OF THE HOME-CALL EXPERIENCE

You have accessJournal of UrologyEducation Research V (PD33)1 Sep 2021PD33-12 EVALUATION OF THE CHARACTERISTICS AND URGENCY OF HOME-CALL PAGER COMMUNICATIONS AND UROLOGY TRAINEE-PERCEPTION OF THE HOME-CALL EXPERIENCE Katherine Fero, Thomas Gaither, Cindy Gu, Arielle Radparvar, Delaney Basile, Mostyn Fero, Karim Chamie, Steven Lerman, and Jonathan Bergman Katherine FeroKatherine Fero More articles by this author , Thomas GaitherThomas Gaither More articles by this author , Cindy GuCindy Gu More articles by this author , Arielle RadparvarArielle Radparvar More articles by this author , Delaney BasileDelaney Basile More articles by this author , Mostyn FeroMostyn Fero More articles by this author , Karim ChamieKarim Chamie More articles by this author , Steven LermanSteven Lerman More articles by this author , and Jonathan BergmanJonathan Bergman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002037.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a dearth of research on the subject of pager communications after-hours in the setting of home call. Without a “post-call day”, trainees who take home-call learn and work the day after being on-call. We aimed to characterize the volume and type of pages received overnight, evaluate the urgency of each communication, and report trainee perceptions of their home call experience. METHODS: Pager data was obtained for residents on home call overnight at a single academic hospital from 8/2019- 1/2020. Overnight coverage was defined as 17:00-05:00. The on-call resident is the first responder for consults and urology inpatients. The date, time, type/origin of the page was abstracted. For pages from 23:00-04:00 we prioritized the page subject. All consults were high priority, as were pages about abnormal vital signs, critical lab results and new symptoms. Low priority pages included ‘FYI’ pages about stable patients, administrative requests and questions about future orders. Residents who have rotated at this site were surveyed for their perceptions of the home-call experience. RESULTS: Over 6 months, 979 pages were received by the on-call resident overnight, corresponding to 5 pages per night. Most were regarding patients admitted to urology (56.3%), followed by patient phone calls (15.5%), inpatient consultations (14.8%), ED consultations (11.1%) and other sources (2.3%). Over half of the nights studied (57%) trainees were paged at least once between 23:00-04:00; during those hours 37.9% of pages were low priority, 18.7% medium, and 35.9% high; 7.6% were unable to be characterized. 63% of residents surveyed reported feeling overwhelmed by the volume of overnight pages at least “sometimes”. Most residents (88.9%) underestimated the number of pages received per night. CONCLUSIONS: Residents on home call are frequently paged overnight, though they underestimate the frequency likely representing normalization of receipt of pages. Most pages relate to inpatient needs, but more than a third are low priority and non-urgent. These data should be used to inform quality improvement projects and policy aimed to improve efficiency and quality of healthcare provider communication and patient care, while minimizing disruption and reducing work-related fatigue and stress. Source of Funding: KEF is supported by H&H Lee UCLA Surgical Scholars © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e581-e581 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Fero More articles by this author Thomas Gaither More articles by this author Cindy Gu More articles by this author Arielle Radparvar More articles by this author Delaney Basile More articles by this author Mostyn Fero More articles by this author Karim Chamie More articles by this author Steven Lerman More articles by this author Jonathan Bergman More articles by this author Expand All Advertisement Loading ...

Correlates of the perceived quality of patient-provider communication among German adults.

Since a higher perceived quality of patient-provider communication is known to be associated with improved health outcomes, it is essential to analyze determinants influencing patients' perceived quality of patient-provider communication. Due to the limited knowledge about patient-related influencing factors of quality perception available so far, the objective of this study is to explore and assess determinants of the perceived quality of patient-provider communication with regards to sociodemographic, health-related, healthcare-specific and information-related factors. Linear regression of cross-sectional data from the first wave of Health Information National Trends Survey Germany (n = 2902) was conducted. Independent variables were sociodemographic, health-, healthcare- and information-related factors; the dependent variable was the perceived quality of patient-provider communication. Results show that age, migration background, the perceived quality of healthcare, health-related self-efficacy and trust in health information from health professionals are significantly associated with the perceived quality of patient-provider communication. Sociodemographic, healthcare- and health information-related factors influence the perceived quality of patient-provider communication. In particular, patients having a migration background and patients reporting low self-efficacy showed significant lower levels of their perceived patient-provider communication quality. With the aim to improve quality issues, patients of both target groups should be empowered and supported.

Associations between patient experience and clinical outcomes in substance use disorder clinics: Findings from the veterans outcomes assessment survey

BackgroundPatient-centeredness is a cornerstone of substance use disorder (SUD) treatment. Patient-experience measures are potential tools for the routine assessment of patient-centered SUD care and may be valuable measures to inform quality monitoring improvement efforts. Little research exists on the predictive validity of patient-experience measures in SUD care. PurposeWe report on findings from the Veterans Outcome Assessment (VOA) survey that provides information on Veterans Health Administration SUD specialty care at treatment initiation and approximately 3-months post-initiation. MethodsThe VOA includes patient-reported outcomes across multiple domains, including the Brief Addiction Monitor (BAM-R), the Short-Form-12 (SF-12) and the Experience of Care and Health Outcome Survey (ECHO), and provides patient reports of the quality of provider communication and overall quality of SUD care. ResultsNearly 40% of veterans in SUD care gave the highest possible ratings for communication and quality at both baseline and follow-up. Ratings of communication at 3-months were associated with treatment discontinuation and both ratings of communication and quality at 3-months and were independently associated with SUD symptoms and with mental well-being at 3-months. ConclusionsThis study provides preliminary support for the inclusion of patient experience measures, particularly ratings of provider communication, as part of routine assessment in SUD care. However, further work on the validity of ratings of provider communication using additional methodologies is likely important before piloting the inclusion of such measures in routine assessment, such as in measurement base care.

Self-Regulation Strategies Among Community-Dwelling People Aging With Arthritis and Multimorbidity.

Self-regulation strategies of selection, optimization, and compensation (SR-SOC) have been found to predict arthritis self-efficacy and quality of life among community-dwelling people aging with arthritis and multimorbidity. The current study aimed to describe the health resources and chronic disabling symptom characteristics of community-dwelling people aging with arthritis and multimorbidity and investigate how these characteristics influence and predict SR-SOC strategies in managing arthritis multimorbidity after controlling for demographics and comorbidities. One hundred forty individuals aged >50 years completed surveys on demographics, comorbidities, health resources, symptoms, and SR-SOC strategy use frequencies. Descriptive statistics were used to describe sample characteristics. Correlations and multivariate hierarchical stepwise regressions were used to examine the associated characteristics and predictors for SR-SOC strategy use frequency. Lower health literacy, health care provider communication quality, and smaller social network were reported less often than arthritis in general. Significant predictors of SR-SOC strategy use were physical symptoms, health care provider communication quality, and age (p < 0.05). Better symptom management and health care provider communication quality could help promote self-regulation. [Journal of Gerontological Nursing, 47(1), 35-45.].

Discharge Communication of Medications for Hospitalized Pediatric Patients and Caregivers

Background: Effective discharge communication is essential for reducing medication errors at home, a leading cause of harm that particularly impacts pediatric patients and caregivers with limited English proficiency (LEP). Little is known about the quality of provider communication of medications to patients and caregivers at the time of hospital discharge. Purpose: To characterize nurse communication of medications at the time of hospital discharge for hospitalized children. Methods: This was a cross-sectional study using direct structured observation of hospital discharges by trained observers at a freestanding children’s hospital. We included conveniently sampled discharge encounters of …

SELF-REGULATION STRATEGIES IN MANAGING MULTI-MORBIDITIES AMONG COMMUNITY-DWELLING PEOPLE AGING WITH ARTHRITIS

Quantitative and qualitative evidence supported the self-regulation strategies of Selection, Optimization and Compensation (SR-SOC), used by people aging with single and multiple chronic conditions (MCCs) to adapt to chronic disabling symptoms and live well. This study investigated the SR-SOC Strategies in the self-management of community-dwelling people aging with arthritis and MCCs. 140 individuals aged > 50 completed the demographic questionnaire, Functional Comorbidity Index (FCI), Brief Health Literacy Screening, Lubben Social Network Scale, Patient-Healthcare Provider Communication Scale, Health Insurance Check-list, PROMIS Adult Self-Reported Health Measures, SOC Questionnaire, Arthritis Self-Efficacy Scale, Healthcare Service Utilization Questionnaire, and a visual analogue QOL scale. With the theoretical framework, multivariate hierarchical stepwise regression was used to predict SR-SOC Strategies, arthritis self-efficacy, healthcare utilizations and QOL. Majority of the sample were female (70%), with < Bachelor’s degree (56%), White (34%) or African American (33%), with personal annual income < $25,000 (52%). Thirty-seven percent reported fairly and 26% poorly adequate income. Number of FCI count ranged from 2 to 14 (Mean =3.8). The top four comorbidities were obesity, diabetes, visual impairment and degenerative disc disease. QOL ranged from 0.5 to 10.0 (Mean=7.2, SD=2.2). Age, physical symptom cluster (pain, fatigue and cognitive abilities) and healthcare provider communication quality significantly predicted SR-SOC strategies. Income adequacy, physical symptom cluster and SR-SOC strategies significantly predicted arthritis self-efficacy. FCI significantly predicted healthcare utilization total, inpatient healthcare utilization, clinician visit and hospitalization. With income adequacy, FCI significantly predicted home health visit and emergency room visit. Being African American and FCI significantly predicted prescriptions filled.

Patient-Centered Care: An Examination of Provider-Patient Communication Over Time.

Objective:To examine the quality of provider communication over time considering the increasing emphasis on patient-centered care (PCC). Patient-centered care has been shown to have a positive impact on health outcomes, care experiences, quality-of-life, as well as decreased costs. Given this emphasis, we expect that provider–patient communication has improved over time.Data Source:We collected primary data by self-report surveys between summer 2017 and fall 2018.Study Design:We use a quantitative retrospective cohort study of a national sample of 353 patients who had an ostomy surgery.Data Extraction Method:We measure provider communication from open-ended self-reports from patients of the number of stated inadequacies in their care.Principal Findings:Results show that the time since patients had their surgery is related to higher quality provider communication. That is, patients who had their surgery further back in time reported higher quality provider communication compared with patients who had their surgery performed more recently.Conclusion:Results suggest that the quality of provider communication has not improved even with an emphasis on PCC.

Professional Interpreter Use and Discharge Communication in the Pediatric Emergency Department

ObjectiveFamilies with limited English proficiency (LEP) experience communication barriers and are at risk for adverse events after discharge from the pediatric emergency department (ED). We sought to describe the characteristics of ED discharge communication for LEP families and to assess whether the use of a professional interpreter was associated with provider communication quality during ED discharge. MethodsTranscripts of video-recorded ED visits for Spanish-speaking LEP families were obtained from a larger study comparing professional interpretation modalities in a freestanding children's hospital. Caregiver-provider communication interactions that included discharge education were analyzed for content and for the techniques that providers used to assess caregiver comprehension. Regression analysis was used to assess for an association between professional interpreter use and discharge education content or assessment of caregiver comprehension. ResultsWe analyzed 101 discharge communication interactions from 47 LEP patient visits; 31% of communications did not use professional interpretation. Although most patients (70%) received complete discharge education content, only 65% received instructions on medication dosing, and only 55% were given return precautions. Thirteen percent of the patient visits included an open-ended question to assess caregiver comprehension, and none included teach-back. Professional interpreter use was associated with greater odds of complete discharge education content (odds ratio [OR], 7.1; 95% confidence interval [CI], 1.4–37.0) and high-quality provider assessment of caregiver comprehension (OR, 6.1; 95% CI, 2.3–15.9). ConclusionsProfessional interpreter use is associated with superior provider discharge communication behaviors. This study identifies clear areas for improving discharge communication, which may improve safety and outcomes for LEP children discharged from the ED.

Mental Health Screening Results Associated with Women Veterans' Ratings of Provider Communication, Trust, and Care Quality.

Identifying factors influencing patient experience and communication with their providers is crucial fortailoring comprehensive primary care for women veterans within the Veterans Health Administration. In particular, the impact of mental health (MH) conditions that are highly prevalent among women veterans is unknown. From January to March 2015, we conducted a cross-sectional survey of women veterans with three or more primary care and/or women's health visits in the prior year at 12 Veterans Health Administration sites. Patient measures included ratings of provider communication, trust in provider, and care quality; demographics, health status, health care use; and brief screeners for symptoms of depression, anxiety, and posttraumatic stress disorder. We used multivariate models to analyze associations of patient ratings and characteristics. Among the 1,395 participants, overall communication ratings were high, but significant variations were observed among women screening positive for MH conditions. In multivariate models, high communication ratings were less likely among women screening positive for multiple MH conditions compared with patients screening negative (odds ratio, 0.43; p<.001). High trust in their provider and high care ratings were significantly less likely among women with positive MH screens. Controlling for communication, the effect of MH on trust and care ratings became less significant, whereas the effect of communication remained highly significant. Women veterans screening positive for MH conditions were less likely to give high ratings for provider communication, trust, and care quality. Given the high prevalence of MH comorbidity among women veterans, it is important to raise provider awareness about these differences, and to enhance communication with patients with MH symptoms in primary care.

Medical Care Avoidance Among Older Adults.

Objective: To examine factors and reasons associated with medical care avoidance among older adults in the United States. Method: Analysis of data on 2,155 adults aged 65 and older, who completed the 2008 Health Information National Trends Survey. Results: Nearly one fourth of older adults reported medical care avoidance (n = 449; weighted % = 22.5%). Of these, more than one third reported doing so because of feeling uncomfortable when their body is examined (34.5%) or fearing a serious illness (35.9%) and with fewer reporting avoiding care because it made them think of dying (14.3%). Likelihood of avoidance was higher among those with worse self-reported health status, severe psychological distress, lower health self-efficacy, lower confidence in obtaining health information, lower trust in doctors, less patient-centered communication, lower perceived health care quality, and those who were current smokers. Qualitative reasons for avoidance corroborated quantitative results. Conclusion: Avoidance by older adults appears to be largely associated with evaluations of the quality of care and provider communication.

Quality and Content of Patient–Provider Communication About Contraception: Differences by Race/Ethnicity and Socioeconomic Status

IntroductionResearch in family planning has shown that contraceptive counseling has an influence on women's family planning outcomes, but also that women are often dissatisfied with the counseling they receive. Little is known about how contraceptive counseling is conducted in the United States. We describe both the content and interpersonal quality of provider communication during family planning visits, as well as assess whether disparities in counseling exist by patient race/ethnicity and socioeconomic status. MethodsWe obtained audio recordings of contraceptive counseling clinic visits for 339 women ages 15-45, which were coded for content and quality of communication, and collected surveys regarding demographics, contraceptive preferences, and experience with care. We performed descriptive analyses of the content and quality of provider–patient communication, and conducted multivariate logistic regression to assess for racial/ethnic and socioeconomic differences in care. ResultsProviders frequently did not communicate with patients about issues relevant to their family planning needs, including their pregnancy intention (assessed in 51% of visits) and their preferences for birth control (64% of visits). Providers also inconsistently offered patients a chance to ask questions (53% of visits). For most measures, there were no differences by patient race/ethnicity and highest level of parental education achieved. Patients whose parents had a high school education or less were significantly less likely to have long-acting reversible contraceptive methods mentioned during the visit (adjusted odds ratio, 0.42; p = .03). ConclusionsSeveral deficiencies in contraceptive counseling were found, suggesting areas for further emphasis in training. Differences by race/ethnicity and socioeconomic states were not marked.

Satisfaction among lung cancer (LCa) patients (pts) in multidisciplinary (MDC) vs. serial care (SC) settings.

e18254 Background: Coordinated MDC, in which all key specialists concurrently provide early input, develop and execute a consensus plan of care in collaboration with pts and their caregivers, may improve satisfaction with care. We rigorously evaluated this premise. Methods: Prospective clinical cohort study comparing newly-diagnosed LCa pts receiving MDC (n=156) or SC (n=307) in the same healthcare system. Pts were enrolled before treatment onset. At baseline (study entry) and 3 months later, pts and caregivers completed treatment-related measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, including perceptions of quality of care, satisfaction with care, and extent of involvement in decision making. Satisfaction indices at 3 months will be compared in multiple linear regression models, adjusting for baseline scores and demographic and treatment-related characteristics. Results: Pt characteristics were similar, except for age and stage (Table). At baseline, MDC pts rated their care more positively than SC pts, but satisfaction with provider communication was similar. Three month data are currently being analyzed. Conclusions: MDC provided greater pt satisfaction in the diagnostic phase of LCa care. Further prospective analyses will test the hypothesis that MDC pts experience greater satisfaction with quality of care and provider communication compared to SC pts. Clinical trial information: NCT02123797. [Table: see text]

Social and material aspects of life and their impact on the physical health of people diagnosed with mental illness.

BackgroundPeople diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts.ObjectiveTo elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health‐care services.DesignQualitative exploratory design involving focus groups.Setting and participantsThe research was conducted in the Australian Capital Territory. Participants were consumers of mental health services.Main outcome measuresThe Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts.ResultsIssues impacting consumers included poverty, the neglect of public services and being treated as second‐class citizens because of diagnosis of mental illness and/or experiencing a psychosocial disability. These factors were connected with significant barriers in accessing physical health care, including the quality and relevance of health provider communication, especially when the broader contexts of mental health consumer's lives are not well understood.Discussion and conclusionsThese findings suggest the Commission on Social Determinants of Health Framework could be utilized in research and policy, and may provide an effective platform for exploring better health communication with mental health consumers regarding this neglected health inequity.

The association between parent-reported provider communication quality and child obesity status: Variation by parent obesity and child race/ethnicity

ObjectiveTo examine the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. MethodsWe conducted a cross-sectional secondary data analysis with the 2011–2013 Medical Expenditures Panel Survey of parents with children ages 6–12 (n=5390). We used multivariable logistic regression to examine the association of parent-reported healthcare provider communication quality (explaining well, listening carefully, showing respect, and spending enough time) with child obesity status, and effect modification by parent obesity and child race/ethnicity. ResultsParents of obese children were more likely to report that their child’s healthcare provider listened carefully (OR=1.41, p=0.002) and spent enough time (OR=1.33, p=0.022) than parents of non-obese children. Non-obese parents of obese children experienced better communication in the domains of listening carefully (p<0.001) and spending enough time (p=0.007). Parents of obese non-Hispanic Asian children and non-Hispanic Black children were more likely to report that providers explained things well (p=0.043) and listened carefully (p=0.012), respectively. ConclusionParents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian. Practice implicationsHealthcare providers should ensure effective communication with obese parents of obese children.

Race/Ethnicity and Health Care Communication: Does Patient-Provider Concordance Matter?

Although many minority patients would prefer a provider of their own race/ethnicity, the influence of this relationship on patient-provider communication remains unknown. This analysis examined the effect of patient-provider race/ethnicity concordance on patient-reported provider communication quality using data from the Medical Expenditure Panel Survey years 2002-2012. Ordinary least squares regressions were executed on communication rating, measured by the Consumer Assessment of Health Providers and Systems. Only 13.8% of black, non-Hispanic patients reported their usual source of care provider matched their race/ethnicity, compared with 94.4% of white, non-Hispanic patients and 43.8% of Hispanic patients. Differences in communication ratings were driven by patient race, rather than provider race. Although black, non-Hispanic patients rate their communication significantly higher than their counterparts overall, there was no significant influence of patient-provider racial concordance on ratings of communication when controlling for other sociodemographic variables. Minorities may seek the services of minority providers, but they are not more satisfied with patient-provider communication experience than when in race-discordant provider arrangements.

Patient perceptions of physician-documented quality care in epilepsy.

The aim of this study was to compare physician encounter documentation with patient perceptions of quality of epilepsy care and examine the association between quality and patient assessment of provider communication. We identified 505 adult patients with epilepsy aged 18years or older over a 3-year period in two large academic medical centers. We abstracted individual, clinical, and care measures from 2723 electronic clinical notes written by physicians. We then randomly selected 245 patients for a phone interview. We compared patient perceptions of care with the documented care for several established epilepsy quality measures. We also explored the association of patient's perception of provider communication with provider documentation of key encounter interventions. There were 88 patients (36%) who completed the interviews. Fifty-seven (24%) refused to participate, and 100 (40%) could not be contacted. Participants and nonparticipants were comparable in their demographic and clinical characteristics; however, participants were more often seen by epilepsy specialists than nonparticipants (75% vs. 61.9%, p<0.01). Quality scores based on patient perceptions differed from those determined by assessing the documentation in the medical record for several quality measures, e.g., documentation of side effects of antiseizure therapy (p=0.05), safety counseling (p<0.01), and counseling for women of childbearing potential with epilepsy (McNemar's p=0.03; intraclass correlation coefficient, ICC=0.07). There was a significant, positive association between patient-reported counseling during the encounter (e.g., personalized safety counseling) and patient-reported scores of provider communication (p=0.05). The association between the patient's recollection of counseling during the visit and his/her positive perception of the provider's communication skills highlights the importance of spending time counseling patients about their epilepsy and not just determining if seizures are controlled.

Disparities in perceived patient–provider communication quality in the United States: Trends and correlates

ObjectiveThis study aimed to describe disparities and temporal trends in the level of perceived patient–provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ. MethodsA cross-sectional analysis was conducted using nationally-representative data from the 2011–2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations. ResultsPPPCQ scores, the composite measure of patients’ ratings of communication quality, were positive overall (82.8; 95% CI: 82.1–83.5). However, less than half (42–46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors. ConclusionsDisparities in PPPCQ can be attributed to patients’ age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health. Practice implicationsThese findings may inform educational and policy efforts which aim to improve patient–provider communication, enhance the quality of care, and reduce health disparities.

Provider communication quality: Influence of patients’ weight and race

ObjectiveTo examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. MethodsWe conducted a cross-sectional analysis with 2009–2010 medical expenditures panel survey–household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient–provider communication measures, and whether patient race/ethnicity modifies this relationship. ResultsCompared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). ConclusionOur study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Practice ImplicationCurricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients.