Journal of Immigrant and Minority Health

, Volume 16, Issue 2, pp 195–203 | Cite as

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

Original Paper

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.

Keywords

Hispanic Healthcare disparities Language Patient satisfaction Provider communication Acculturation Patient-provider concordance 

References

  1. 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.CrossRefGoogle Scholar
  2. 2.
    Ferguson WJ, Candib LM. Culture, language, and the doctor-patient relationship. Fam Med. 2002;34:353–61.PubMedGoogle Scholar
  3. 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.PubMedCrossRefGoogle Scholar
  4. 4.
    Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152:1423–33.PubMedCentralPubMedGoogle Scholar
  5. 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.PubMedCrossRefGoogle Scholar
  6. 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.PubMedCrossRefGoogle Scholar
  7. 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. 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. 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.PubMedCrossRefGoogle Scholar
  10. 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.PubMedGoogle Scholar
  11. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 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.PubMedCrossRefGoogle Scholar
  13. 13.
    LaVeist TA, Carroll T. Race of physician and satisfaction with care among African-American patients. J Natl Med Assoc. 2002;94:937–43.PubMedCentralPubMedGoogle Scholar
  14. 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.PubMedCrossRefGoogle Scholar
  15. 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.PubMedCrossRefGoogle Scholar
  16. 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.CrossRefGoogle Scholar
  17. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    van Wieringen JC, Harmsen JA, Bruijnzeels MA. Intercultural communication in general practice. Eur J Public Health. 2002;12:63–8.PubMedCrossRefGoogle Scholar
  19. 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.PubMedGoogle Scholar
  20. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 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.PubMedCrossRefGoogle Scholar
  24. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 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. 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.PubMedCrossRefGoogle Scholar
  27. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff (Millwood). 2000;19:76–83.CrossRefGoogle Scholar
  32. 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.PubMedCrossRefGoogle Scholar
  33. 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.PubMedCrossRefGoogle Scholar
  34. 34.
    Kirby JB, Taliaferro G, Zuvekas SH. Explaining racial and ethnic disparities in health care. Med Care. 2006;44:I64–72.PubMedCrossRefGoogle Scholar
  35. 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.PubMedGoogle Scholar
  36. 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.PubMedCrossRefGoogle Scholar
  37. 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.Google Scholar
  38. 38.
    Mosen DM, Carlson MJ, Morales LS, Hanes PP. Satisfaction with provider communication among Spanish-speaking Medicaid enrollees. Ambul Pediatr. 2004;4:500–4.PubMedCentralPubMedCrossRefGoogle Scholar
  39. 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.PubMedCrossRefGoogle Scholar
  40. 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.CrossRefGoogle Scholar
  41. 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.PubMedCrossRefGoogle Scholar
  42. 42.
    Cabassa LJ. Measuring acculturation: where we are and where we need to go. Hispanic J Behav Sci. 2003;25:127–46.CrossRefGoogle Scholar
  43. 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.PubMedCrossRefGoogle Scholar
  44. 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.PubMedCrossRefGoogle Scholar
  45. 45.
    Aday LA, Andersen R. A framework for the study of access to medical care. Health Serv Res. 1974;9:208–20.PubMedCentralPubMedGoogle Scholar
  46. 46.
    Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36:1–10.PubMedCrossRefGoogle Scholar
  47. 47.
    Sinning M, Hahn M, Bauer TK. The Blinder-Oaxaca decomposition for nonlinear regression models. Stata J. 2008;8:480–92.Google Scholar
  48. 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.PubMedCrossRefGoogle Scholar
  49. 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.PubMedCentralPubMedGoogle Scholar
  50. 50.
    DeVoe JE, Wallace LS, Fryer GE Jr. Patient age influences perceptions about health care communication. Fam Med. 2009;41:126–33.PubMedGoogle Scholar
  51. 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.PubMedCrossRefGoogle Scholar
  52. 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.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of Health Services AdministrationUniversity of Maryland School of Public HealthCollege ParkUSA

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