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弱势患者与医疗服务提供者的关系:与健康素养、医疗连续性及自评健康的关联

Patient-Provider Relationships Among Vulnerable Patients: The Association With Health Literacy, Continuity of Care, and Self-Rated Health.

作者信息

Kamimura Akiko, Higham Rebecca, Rathi Naveen, Panahi Samin, Lee Edward, Ashby Jeanie

机构信息

University of Utah, Salt Lake City, UT, USA.

Maliheh Free Clinic, Salt Lake City, UT, USA.

出版信息

J Patient Exp. 2020 Dec;7(6):1450-1457. doi: 10.1177/2374373519895680. Epub 2020 Jan 12.

Abstract

While the patient-provider relationship is one factor that can improve access to primary care for underserved populations, vulnerable patients often experience challenges to have a good relationship with providers. The purpose of this study is to examine factors that affect patient-provider relationship among vulnerable patients; in particular, among uninsured primary care patients. This study focused on health literacy, continuity of care, and self-rated health as predictors of patient-provider relationship. A self-administered survey was collected from uninsured primary care patients utilizing a free clinic in the metropolitan area in the Rocky Mountain Region in the United States from May to July in 2018. Higher levels of health literacy and continuity of care are associated with a better patient-provider relationship. Better self-rated health is associated with better patient-provider relationship. Health literacy may improve by the communication and connection with a specific provider because patients better understand the care and/or medications that are being prescribed. Seeing the same provider helps patients develop a better relationship and make clinical decisions in a way that they prefer. Improving the patient-provider relationship can potentially change health outcomes positively for vulnerable patients. Informing patients that they can request a specific medical provider may allow them to increase continuity of care, and improve communication, partnering, connection, and patient centeredness, leading to an increase in health literacy and better self-rated health.

摘要

虽然医患关系是改善弱势群体获得初级医疗服务机会的一个因素,但弱势患者在与医疗服务提供者建立良好关系方面往往面临挑战。本研究的目的是探讨影响弱势患者,特别是未参保初级医疗患者医患关系的因素。本研究将健康素养、医疗连续性和自评健康状况作为医患关系的预测指标。2018年5月至7月,我们在美国落基山地区大都市的一家免费诊所,对未参保的初级医疗患者进行了一项自填式调查。较高的健康素养水平和医疗连续性与较好的医患关系相关。较好的自评健康状况与较好的医患关系相关。与特定医疗服务提供者的沟通和联系可能会提高健康素养,因为患者能更好地理解所开的治疗和/或药物。看同一位医疗服务提供者有助于患者建立更好的关系,并以他们喜欢的方式做出临床决策。改善医患关系可能会对弱势患者的健康结果产生积极影响。告知患者他们可以要求指定特定的医疗服务提供者,可能会使他们提高医疗连续性,改善沟通、合作、联系以及以患者为中心的程度,从而提高健康素养水平并改善自评健康状况。

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