Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea; L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea.
Department of Medicine and Public Health Sciences, Division of Biological Sciences, University of Chicago, Chicago, Illinois.
Am J Prev Med. 2024 Nov;67(5):740-745. doi: 10.1016/j.amepre.2024.07.004. Epub 2024 Jul 28.
Effective patient-provider communication is a critical component of optimal patient care, but its potential impact on the delivery of healthcare services remains unclear. This study examines the association of patient-provider communication with access to care, healthcare utilization, and financial burden of care.
Using the 2013-2021 Medical Expenditure Panel Survey longitudinal data, the level of patient-provider communication was measured across four domains (attentive listening, clear explanation, respectfulness, and time allocation) as a primary independent variable, categorized into low, moderate, and high. A lagged dependent model was employed to examine the associations of patient-provider communication at baseline with subsequent access to care, healthcare utilization, and financial burden of care, controlling for baseline sample characteristics and outcomes measured at the baseline. Analysis was conducted in February 2024.
Among 28,955 analytic samples (representing 709,547,678 U.S. adults), 5.3%, 50.2%, and 44.3% reported low, moderate, and high levels of patient-provider communication. Marginalized populations, including racial/ethnic minorities, those with low education and income, and those lacking insurance, were more likely to report low patient-provider communication. Compared with adults with high patient-provider communication, those with low patient-provider communication were more likely to encounter difficulties in accessing medical care (2.6 percentage points; 95% CI: 1.2-3.9), experience delays in obtaining necessary medical care (2.8 percentage points; 1.3-4.4), have emergency room visits (4.2 percentage points; 1.9-6.4), and face difficulties paying medical bills (4.0 percentage points; 2.2-5.8) in the subsequent year.
Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities.
有效的医患沟通是优化患者护理的关键组成部分，但它对医疗服务提供的潜在影响尚不清楚。本研究考察了医患沟通与获得医疗保健、医疗保健利用和医疗保健负担财务之间的关联。
使用 2013-2021 年医疗支出面板调查纵向数据，将医患沟通水平分为四个领域（注意力倾听、清晰解释、尊重和时间分配）作为主要自变量，分为低、中、高三个等级。采用滞后依赖模型，在控制基线样本特征和基线测量的结果后，检验基线时医患沟通与随后获得医疗保健、医疗保健利用和医疗保健负担财务的关联。分析于 2024 年 2 月进行。
在 28955 个分析样本（代表 709547678 名美国成年人）中，5.3%、50.2%和 44.3%报告了低、中、高水平的医患沟通。弱势群体，包括种族/族裔少数群体、受教育程度和收入较低的群体以及缺乏保险的群体，更有可能报告低水平的医患沟通。与具有高水平医患沟通的成年人相比，具有低水平医患沟通的成年人更有可能在获得医疗保健方面遇到困难（2.6 个百分点；95%CI：1.2-3.9）、在获得必要医疗保健方面出现延迟（2.8 个百分点；1.3-4.4）、去急诊室就诊（4.2 个百分点；1.9-6.4）以及在次年面临支付医疗账单的困难（4.0 个百分点；2.2-5.8）。
鼓励有效的医患沟通对于推进以患者为中心的护理和减轻健康不平等至关重要。
