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患者激活在美籍和外国出生的拉丁裔患者的医患沟通和医疗质量中的作用。

The role of patient activation on patient-provider communication and quality of care for US and foreign born Latino patients.

机构信息

Center for Multicultural Mental Health Research, Cambridge Health Alliance and Harvard Medical School, 120 Beacon Street, 4th Floor, Somerville, MA, 02143, USA.

出版信息

J Gen Intern Med. 2009 Nov;24 Suppl 3(Suppl 3):534-41. doi: 10.1007/s11606-009-1074-x.

Abstract

BACKGROUND

Previous research has shown positive effects of patient activation on healthcare outcomes, but there is practically no information on the generalization of these findings for Latino patients. Little data are available on whether patient activation is associated with healthcare outcomes for Latino patients and whether activation varies by language proficiency and nativity status.

OBJECTIVE

We examined the levels of activation by characteristics of Latino patients (e.g. nativity, language, health status). We investigated whether patient activation relates to the quality of care received and enhanced doctor-patient communication for Latino patients.

DESIGN

We conducted analyses of 1,067 US born and foreign born Latinos who participated in the second wave of the PEW/RWJF Hispanic Healthcare Survey during 2008.

PARTICIPANTS

Participants were self-identified Latinos (18+) with a doctor visit, living in the contiguous United States who could be contacted by telephone.

RESULTS

US born Latinos had significantly (P < 0.001) greater patient activation scores than foreign born Latinos (75 versus 70). Latinos classified as bilingual and those reporting excellent health evidenced higher mean activation scores as compared to Spanish-speaking Latinos and those reporting fair or poor health. After adjusting for demographics, health status, other language and service use factors, patient activation was strongly associated with self-reported quality of care and better doctor-patient communication among both US and foreign born Latino respondents.

CONCLUSIONS

Interventions that augment patient activation could increase quality of care and improved patient-provider communication, potentially reducing health care disparities for Latinos.

摘要

背景

先前的研究表明患者激活对医疗保健结果有积极影响,但实际上没有关于这些发现对拉丁裔患者的推广的信息。关于患者激活是否与拉丁裔患者的医疗保健结果相关,以及激活是否因语言熟练程度和出生地点而异,几乎没有数据。

目的

我们通过拉丁裔患者的特征(例如出生地、语言、健康状况)来检查激活水平。我们调查了患者激活是否与拉丁裔患者接受的护理质量和增强医患沟通有关。

设计

我们对参加 2008 年 PEW/RWJF 西班牙裔医疗保健调查第二波的 1067 名美国出生和外国出生的拉丁裔患者进行了分析。

参与者

参与者是自我认同的拉丁裔(18 岁以上),有过就诊经历,居住在美国大陆,能够通过电话联系。

结果

美国出生的拉丁裔患者的患者激活评分明显(P < 0.001)高于外国出生的拉丁裔患者(75 分比 70 分)。被归类为双语的拉丁裔患者和报告健康状况极佳的患者,与只会说西班牙语的拉丁裔患者和报告健康状况一般或较差的患者相比,平均激活评分更高。在调整了人口统计学、健康状况、其他语言和服务使用因素后,患者激活与美国和外国出生的拉丁裔患者报告的自我报告的护理质量和更好的医患沟通密切相关。

结论

增强患者激活的干预措施可以提高护理质量和改善患者-提供者沟通,从而减少拉丁裔患者的医疗保健差距。

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