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乳腺癌患者与医疗服务提供者沟通中的种族和族裔差异:来自2011年医疗支出面板调查及癌症补充调查的证据

Racial and Ethnic Disparities in Patient-Provider Communication With Breast Cancer Patients: Evidence From 2011 MEPS and Experiences With Cancer Supplement.

作者信息

White-Means Shelley I, Osmani Ahmad Reshad

机构信息

1 The University of Tennessee Health Science Center, Memphis, USA.

2 The University of Memphis, TN, USA.

出版信息

Inquiry. 2017 Jan 1;54:46958017727104. doi: 10.1177/0046958017727104.

Abstract

The current study explores racial/ethnic disparities in the quality of patient-provider communication during treatment, among breast cancer patients. A unique data set, Medical Expenditure Panel Survey and Experiences With Cancer Supplement 2011, is used to examine this topic. Using measures of the quality of patient-provider communication that patients are best qualified to evaluate, we explore the relationship between race/ethnicity and patients' perspectives on whether (1) patient-provider interactions are respectful, (2) providers are listening to patients, (3) providers provide adequate explanations of outcomes and treatment, and (4) providers spend adequate time in interacting with the patients. We also examine the relationship between race/ethnicity and patients' perspectives on whether their (1) doctor ever discussed need for regular follow-up care and monitoring after completing treatment, (2) doctor ever discussed long-term side effects of cancer treatment, (3) doctor ever discussed emotional or social needs related to cancer, and (4) doctor ever discussed lifestyle or health recommendations. Multivariate ordinary least squares and ordered logistic regression models indicate that after controlling for factors such as income and health insurance coverage, the quality of patient-provider communication with breast cancer patients varies by race/ethnicity. Non-Hispanic blacks experience the greatest communication deficit. Our findings can inform the content of future strategies to reduce disparities.

摘要

本研究探讨了乳腺癌患者在治疗期间医患沟通质量方面的种族/族裔差异。我们使用了一个独特的数据集——《医疗支出面板调查与2011年癌症补充调查》来研究这一主题。我们采用了患者最有资格评估的医患沟通质量衡量指标,探讨种族/族裔与患者对以下方面看法之间的关系:(1)医患互动是否尊重患者;(2)医生是否倾听患者意见;(3)医生是否对治疗结果和治疗方法进行了充分解释;(4)医生与患者互动的时间是否充足。我们还研究了种族/族裔与患者对以下方面看法之间的关系:(1)医生是否曾讨论过治疗结束后定期随访护理和监测的必要性;(2)医生是否曾讨论过癌症治疗的长期副作用;(3)医生是否曾讨论过与癌症相关的情感或社会需求;(4)医生是否曾讨论过生活方式或健康建议。多元普通最小二乘法和有序逻辑回归模型表明,在控制了收入和医疗保险覆盖等因素后,乳腺癌患者的医患沟通质量因种族/族裔而异。非西班牙裔黑人经历的沟通障碍最大。我们的研究结果可为未来减少差异的策略内容提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cf7/5798717/873a685c3c0e/10.1177_0046958017727104-fig1.jpg

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