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Decomposing the Gap in Satisfaction with Provider Communication Between English- and Spanish-Speaking Hispanic Patients

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Abstract

Disparities in patient-provider communication exist among racial/ethnic groups. Hispanics report the lowest satisfaction with provider communication compared to whites and blacks; these differences may be due to level of acculturation or patient-provider concordance according to their ability to speak English. Using data from the 2007–2009 Medical Expenditure Panel Survey, this study identifies and quantifies the components that constitute the gap in satisfaction with provider communication between English- and Spanish-speaking Hispanics. English-speaking Hispanics are 7.3 percentage points more likely to be satisfied with the amount of time their providers spent with them compared to Spanish-speaking Hispanics. Differences in acculturation between the two groups account for 77 % of this gap. Satisfaction with provider listening is 6.8 percentage points higher for English-speaking Hispanics. Hispanics who speak English are more satisfied with provider communication. The gap in satisfaction is largely attributable to differences in health insurance, acculturation, and education.

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References

  1. Baker DW, Parker RM, Williams MV, Coates WC, Pitkin K. Use and effectiveness of interpreters in an emergency department. J Amer Med Assoc. 1996;275:783–8.

    Article  CAS  Google Scholar 

  2. Ferguson WJ, Candib LM. Culture, language, and the doctor-patient relationship. Fam Med. 2002;34:353–61.

    PubMed  Google Scholar 

  3. Kaplan SH, Greenfield S, Ware JE Jr. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989;27:S110–27.

    Article  CAS  PubMed  Google Scholar 

  4. Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152:1423–33.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Trummer UF, Mueller UO, Nowak P, Stidl T, Pelikan JM. Does physician-patient communication that aims at empowering patients improve clinical outcome? A case study. Patient Educ Couns. 2006;61:299–306.

    Article  PubMed  Google Scholar 

  6. Street RL Jr, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009;74:295–301.

    Article  PubMed  Google Scholar 

  7. U.S. Department of Health & Human Services. Health Communication and Health Information Technology—Healthy People. [Internet] 2010 [cited 2011 Apr 29]; Available from: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=18.

  8. National Center for Health Statistics. Health Indicators Warehouse. [Internet] Hyattsville, MD: National Center for Health Statistics; 2007 [cited 2011 Aug 26]; Available from: http://www.healthindicators.gov/Indicators/Health-Care_Provider-Communication_138/Selection.

  9. Jensen JD, King AJ, Guntzviller LM, Davis LA. Patient-provider communication and low-income adults: age, race, literacy, and optimism predict communication satisfaction. Patient Educ Couns. 2010;79:30–5.

    Article  PubMed  Google Scholar 

  10. Merrill RM, Allen EW. Racial and ethnic disparities in satisfaction with doctors and health providers in the United States. Ethn Dis. 2003;13:492–8.

    PubMed  Google Scholar 

  11. Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003;93:1713–9.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999;159:997–1004.

    Article  CAS  PubMed  Google Scholar 

  13. LaVeist TA, Carroll T. Race of physician and satisfaction with care among African-American patients. J Natl Med Assoc. 2002;94:937–43.

    PubMed Central  PubMed  Google Scholar 

  14. Laveist TA, Nuru-Jeter A. Is doctor-patient race concordance associated with greater satisfaction with care? J Health Soc Behav. 2002;43:296–306.

    Article  PubMed  Google Scholar 

  15. Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139:907–15.

    Article  PubMed  Google Scholar 

  16. Cooper-Patrick L, Gallo JJ, Gonzales JJ, Vu HT, Powe NR, Nelson C, Ford DE. Race, gender, and partnership in the patient-physician relationship. J Amer Med Assoc. 1999;282:583–9.

    Article  CAS  Google Scholar 

  17. Meghani SH, Brooks JM, Gipson-Jones T, Waite R, Whitfield-Harris L, Deatrick JA. Patient-provider race-concordance: does it matter in improving minority patients’ health outcomes? Ethn Health. 2009;14:107–30.

    Article  PubMed Central  PubMed  Google Scholar 

  18. van Wieringen JC, Harmsen JA, Bruijnzeels MA. Intercultural communication in general practice. Eur J Public Health. 2002;12:63–8.

    Article  PubMed  Google Scholar 

  19. Garcia JA, Paterniti DA, Romano PS, Kravitz RL. Patient preferences for physician characteristics in university-based primary care clinics. Ethn Dis. 2003;13:259–67.

    PubMed  Google Scholar 

  20. Schmittdiel J, Grumbach K, Selby JV, Quesenberry CP Jr. Effect of physician and patient gender concordance on patient satisfaction and preventive care practices. J Gen Intern Med. 2000;15:761–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Gonzalez HM, Vega WA, Tarraf W. Health care quality perceptions among foreign-born Latinos and the importance of speaking the same language. J Am Board Fam Med. 2010;23:745–52.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Fernandez A, Schillinger D, Grumbach K, Rosenthal A, Stewart AL, Wang F, Perez-Stable EJ. Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. J Gen Intern Med. 2004;19:167–74.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Arauz Boudreau AD, Fluet CF, Reuland CP, Delahaye J, Perrin JM, Kuhlthau K. Associations of providers’ language and cultural skills with Latino parents’ perceptions of well-child care. Acad Pediatr. 2010;10:172–8.

    Article  PubMed  Google Scholar 

  24. Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. J Gen Intern Med. 2004;19:101–10.

    Article  PubMed Central  PubMed  Google Scholar 

  25. U.S. Census Bureau. Hispanics in the United States. [Internet] 2008 [cited 2011 Sept 15]; Available from: http://www.census.gov/population/www/socdemo/hispanic/hispanic_pop_presentation.html.

  26. Wallace LS, DeVoe JE, Heintzman JD, Fryer GE. Language preference and perceptions of healthcare providers’ communication and autonomy making behaviors among Hispanics. J Immigr Minor Health. 2009;11:453–9.

    Article  PubMed  Google Scholar 

  27. Wallace LS, DeVoe JE, Rogers ES, Malagon-Rogers M, Fryer GE Jr. The medical dialogue: disentangling differences between Hispanic and non-Hispanic whites. J Gen Intern Med. 2007;22:1538–43.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Wallace LS, DeVoe JE, Rogers ES, Protheroe J, Rowlands G, Fryer GE Jr. Digging deeper: quality of patient-provider communication across Hispanic subgroups. BMC Health Serv Res. 2009;9:240.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Morales LS, Cunningham WE, Brown JA, Liu H, Hays RD. Are Latinos less satisfied with communication by health care providers? J Gen Intern Med. 1999;14:409–17.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Tarn DM, Meredith LS, Kagawa-Singer M, Matsumura S, Bito S, Oye RK, Liu H, Kahn KL, Fukuhara S, Wenger NS. Trust in one’s physician: the role of ethnic match, autonomy, acculturation, and religiosity among Japanese and Japanese Americans. Ann Fam Med. 2005;3:339–47.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff (Millwood). 2000;19:76–83.

    Article  CAS  Google Scholar 

  32. Jimenez-Rubio D, Hernandez-Quevedo C. Inequalities in the use of health services between immigrants and the native population in Spain: what is driving the differences? Eur J Health Econ. 2011;12:17–28.

    Article  PubMed  Google Scholar 

  33. Vargas Bustamante A, Chen J, Rodriguez HP, Rizzo JA, Ortega AN. Use of preventive care services among Latino subgroups. Am J Prev Med. 2010;38:610–9.

    Article  PubMed  Google Scholar 

  34. Kirby JB, Taliaferro G, Zuvekas SH. Explaining racial and ethnic disparities in health care. Med Care. 2006;44:I64–72.

    Article  PubMed  Google Scholar 

  35. Rodriguez HP, Chen J, Rodriguez MA. A national study of problematic care experiences among Latinos with diabetes. J Health Care Poor Underserved. 2010;21:1152–68.

    PubMed  Google Scholar 

  36. Mortensen K, Song PH. Minding the gap: a decomposition of emergency department use by Medicaid enrollees and the uninsured. Med Care. 2008;46:1099–107.

    Article  PubMed  Google Scholar 

  37. Ezzati-Rice T, Rohde F, Greenblatt J. Sample Design of the Medical Expenditure Panel Survey Household Component, 1998–2007. Rockville, MD: 2008 Contract No.: Methodology Report No. 22.

  38. Mosen DM, Carlson MJ, Morales LS, Hanes PP. Satisfaction with provider communication among Spanish-speaking Medicaid enrollees. Ambul Pediatr. 2004;4:500–4.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.

    Article  PubMed  Google Scholar 

  40. Cruz TH, Marshall SW, Bowling JM, Villaveces A. The validity of a proxy acculturation scale among US Hispanics. Hispanic J Behav Sci. 2008;30:425–46.

    Article  Google Scholar 

  41. Arcia E, Skinner M, Bailey D, Correa V. Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med. 2001;53:41–53.

    Article  CAS  PubMed  Google Scholar 

  42. Cabassa LJ. Measuring acculturation: where we are and where we need to go. Hispanic J Behav Sci. 2003;25:127–46.

    Article  Google Scholar 

  43. Doescher MP, Saver BG, Franks P, Fiscella K. Racial and ethnic disparities in perceptions of physician style and trust. Arch Fam Med. 2000;9:1156–63.

    Article  CAS  PubMed  Google Scholar 

  44. Xu KT, Borders TF. Does being an immigrant make a difference in seeking physician services? J Health Care Poor Underserved. 2008;19:380–90.

    Article  PubMed  Google Scholar 

  45. Aday LA, Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974;9:208–20.

    CAS  PubMed Central  PubMed  Google Scholar 

  46. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.

    Article  CAS  PubMed  Google Scholar 

  47. Sinning M, Hahn M, Bauer TK. The Blinder-Oaxaca decomposition for nonlinear regression models. Stata J. 2008;8:480–92.

    Google Scholar 

  48. Rutten LJ, Augustson E, Wanke K. Factors associated with patients’ perceptions of health care providers’ communication behavior. J Health Commun. 2006;11(Suppl 1):135–46.

    Article  PubMed  Google Scholar 

  49. Fiscella K, Goodwin MA, Stange KC. Does patient educational level affect office visits to family physicians? J Natl Med Assoc. 2002;94:157–65.

    PubMed Central  PubMed  Google Scholar 

  50. DeVoe JE, Wallace LS, Fryer GE Jr. Patient age influences perceptions about health care communication. Fam Med. 2009;41:126–33.

    PubMed  Google Scholar 

  51. DeVoe JE, Wallace LS, Fryer GE Jr. Measuring patients’ perceptions of communication with healthcare providers: do differences in demographic and socioeconomic characteristics matter? Health Expect. 2009;12:70–80.

    Article  PubMed  Google Scholar 

  52. Hayes RP, Baker DW. Methodological problems in comparing English-speaking and Spanish-speaking patients’ satisfaction with interpersonal aspects of care. Med Care. 1998;36:230–6.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Health Services Administration, University of Maryland School of Public Health, 3310 School of Public Health Building, College Park, MD, 20742-2611, USA

    Jennifer Villani & Karoline Mortensen

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  1. Jennifer Villani
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  2. Karoline Mortensen
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Correspondence to Karoline Mortensen.

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Villani, J., Mortensen, K. Decomposing the Gap in Satisfaction with Provider Communication Between English- and Spanish-Speaking Hispanic Patients. J Immigrant Minority Health 16, 195–203 (2014). https://doi.org/10.1007/s10903-012-9733-0

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  • DOI: https://doi.org/10.1007/s10903-012-9733-0

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