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Racial/Ethnic Differences in Those Accompanying Medicare Patients to the Doctor: Insights from the 2013 Medicare Current Beneficiary’s Survey

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Abstract

Surprisingly little current, population-level detail exists regarding companion accompaniment for health care among Medicare beneficiaries, particularly by race/ethnicity. For respondents in the 2013 Medicare Current Beneficiary’s Survey Access to Care public use data (N = 12,253), multivariable models predicted accompaniment to the doctor by race/ethnicity, adjusting for confounders. Chi square analyses compared, by race/ethnicity, who was accompanying and why. Overall, 37.5% of beneficiaries had accompaniment. In multivariable analyses, non-Hispanic blacks (OR 1.18; 95% CI 1.03–1.36) and Hispanics (OR 1.47; 95% CI 1.25–1.74) were significantly more likely than non-Hispanic whites to have accompaniment. Over 35% of all three groups had someone to “take notes,” “ask questions,” and/or “explain things,” which did not vary by race/ethnicity; significant differences were seen for “explain instructions,” “translate,” and “moral support.” Hispanics had the highest percentages for all three. Many Medicare beneficiaries have accompaniment to doctors’ appointments, particularly in minority racial/ethnic groups, which should be considered in policy and practice.

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References

  1. Piette J. Editorial: moving beyond the notion of ‘self’ care. Chronic Illn. 2010;6:3–6.

    Article  PubMed  Google Scholar 

  2. Black S, et al. Diabetes literacy and informal social support: a qualitative study of patients at a diabetes centre. J Clin Nurs. 2017;26:248–57. doi:10.1111/jocn.13383.

    Article  PubMed  Google Scholar 

  3. Hinder S, Greenhalgh T. “This does my head in.” Ethnographic study of self-management by people with diabetes. BMC Health Serv Res. 2012;12:83.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Laidsaar-Powell RC, et al. Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. Patient Educ Couns. 2013;91:3–13. doi:10.1016/j.pec.2012.11.007.

    Article  PubMed  CAS  Google Scholar 

  5. Wolff JL, Roter DL. Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Arch Intern Med. 2008;168:1409–15.

    Article  PubMed  Google Scholar 

  6. Wolff JL, Roter DL. Family presence in routine medical visits: a meta-analytical review. Soc Sci Med. 2011;72:823–31.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Elwyn G, et al. Shared decision-making in primary care: the neglected second of the consultation. Br J Gen Pract. 1999;49:477–82.

    PubMed  PubMed Central  CAS  Google Scholar 

  8. Smith KP, Christakis NA. Social networks and health. Ann Rev Sociol. 2008;34:405–29.

    Article  Google Scholar 

  9. Sayers SL, et al. Family involvement in the care of healthy medical outpatients. Fam Pract. 2006;23:317–24.

    Article  PubMed  Google Scholar 

  10. Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. ‎J Health Soc Behav. 2010;51:S54–66.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Valente TW. social networks and health: models, methods, and applications.Oxford: Oxford University Press; 2010.

    Book  Google Scholar 

  12. Vassilev I, et al. The influence of social networks on self-management support: a metasynthesis. BMC Public Health. 2014;14:719.

    Article  PubMed  PubMed Central  Google Scholar 

  13. House JS, et al. Social relationships and health. Science. 1988;241:540–5.

    Article  PubMed  CAS  Google Scholar 

  14. Mead EL, et al. Shared decision-making for cancer care among racial and ethnic minorities: a systematic review. Am J Public Health. 2013;103:e15–e29.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Centers for Disease Control and Prevention: Cultural insights: Communicating with Hispanics/Latinos. 2012. Atlanta: Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/healthcommunication/pdf/audience/audienceinsight_culturalinsights.pdf. Accessed 24 July 2016.

  16. Centers for Disease Control and Prevention Healthy Communities Program: Building Our Understanding: Culture Insights Communicating with Hispanic/Latinos. Available at: https://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/hispanic_latinos_insight.pdf. Accessed 4 Apr 2017.

  17. Peters RM, Aroian KJ, Flack JM. African American culture and hypertension prevention. West J Nurs Res. 2006;28:831–63.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Dilworth-Anderson P, Williams IC, Gibson BE. Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000). Gerontologist. 2002;42:237–72.

    Article  PubMed  Google Scholar 

  19. del Río N. The influence of Latino ethnocultural factors on decision making at the end of life: WITHHOLDING and withdrawing artificial nutrition and hydration. J Soc Work End Life Palliat Care. 2010;6:125–49. doi:10.1080/15524256.2010.529009.

    Article  PubMed  Google Scholar 

  20. Savage B, Foli KJ, Edwards NE, Abrahamson K. Familism and health care provision to Hispanic older adults. J Gerontol Nurs. 2016;42:21–9.

    Article  PubMed  Google Scholar 

  21. Caballero AE. Understanding the Hispanic/Latino patient. Am J Med. 2011;124:S10–5. doi:10.1016/j.amjmed.2011.07.018.

    Article  PubMed  Google Scholar 

  22. Howard DL, et al. Distribution of African Americans in residential care/assisted living and nursing homes: More evidence of racial disparity? Am J Public Health. 2002;92:1272–7.

    Article  PubMed  PubMed Central  Google Scholar 

  23. McCann JJ, et al. Comparison of informal caregiving by black and white older adults in a community population. J Am Geriatr Soc. 2000;48:1612–7.

    Article  PubMed  CAS  Google Scholar 

  24. Navaie-Waliser M, et al. The experiences and challenges of informal caregivers: common themes and differences among whites, blacks, and Hispanics. Gerontologist. 2001;41:733–41.

    Article  PubMed  CAS  Google Scholar 

  25. Centers for Medicare & Medicaid Services CMS Product No. 11034. 2014. Available at: https://www.medicare.gov/Pubs/pdf/11034.pdf. Accessed 24 July 2016.

  26. Centers for Medicare & Medicaid Services Caregiver resource kit. 2016. Available at: https://www.medicare.gov/campaigns/caregiver/caregiver-resource-kit.html. Accessed 24 July 2016.

  27. Betancourt JR, et al. Guide to preventing readmissions among racially and ethnically diverse Medicare beneficiaries. Prepared by the disparities solutions center, mongan institute for health policy at massachusetts general hospital. Baltimore, MD: Centers for Medicare & Medicaid Services Office of Minority Health; 2015.

    Google Scholar 

  28. Ishikawa H, et al. Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters. Soc Sci Med. 2005;60:2307–20.

    Article  PubMed  Google Scholar 

  29. Brown JB, et al. Roles and influence of people who accompany patients on visits to the doctor. Can Fam Physician. 1998;44:1644–50.

    PubMed  PubMed Central  CAS  Google Scholar 

  30. Kuluski K, et al. A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers. BMC Fam Pract. 2013;14:133.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Rosland AM, et al. Family and friend participation in primary care visits of patients with diabetes or heart failure: patient and physician determinants and experiences. Med Care. 2011;49:37–45.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wolff JL, et al. Going it together: persistence of older adults’ accompaniment to physician visits by a family companion. J Am Geriatr Soc. 2012;60:106–12. doi:10.1111/j.1532-5415.2011.03770.x.

    Article  PubMed  Google Scholar 

  33. Centers for Medicare & Medicaid Services. 2013 Medicare Current Beneficiary Survey Public Use File [Data file and code book]. Available from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/MCBS-Public-Use-File/index.html. Accessed 26 Jun 2016.

  34. von Elm E, et al. STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344–9. doi:10.1016/j.jclinepi.2007.11.008.

    Article  Google Scholar 

  35. Retooling for an Aging America: Building the Health Care Workforce. Patients and Informal Caregivers. Institute of Medicine (US) Committee on the Future Health Care Workforce for Older Americans. Washington DC: National Academies Press (US); 2008. Available from: https://www.ncbi.nlm.nih.gov/books/NBK215403/. Accessed 4 Apr 2017.

  36. Cené CW, et al. The effect of patient race and blood pressure control on patient-physician communication. J Gen Intern Med. 2009;24:1057–64.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Johnson RL, et al. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Public Health. 2004;94:2084–90.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Roter DL, et al: Patient and family empowerment as agents of ambulatory care safety and quality. BMJ Qual Saf. 2016. doi:10.1136/bmjqs-2016-005489.

    Article  PubMed  Google Scholar 

  39. Clayman ML, et al. Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. ‎Soc Sci Med. 2005;60:1583–91.

    Article  PubMed  Google Scholar 

  40. Wolff JL, et al. A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study. J Am Geriatr Soc. 2014;62:312–19.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Rosland AM, et al. Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chronic Illn. 2010;6:22–33.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Bookwala J, Marshall KI, Manning SW. Who needs a friend? Marital status transitions and physical health outcomes in later life. Health Psychol. 2014;33:505–15.

    Article  PubMed  Google Scholar 

  43. King GL, et al. Understanding and addressing unique needs of diabetes in Asian Americans, native Hawaiians, and Pacific Islanders. Diabetes Care. 2012;35:1181–8.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Aitaoto N, et al. Design and results of a culturally tailored cancer outreach project by and for Micronesian women. Prev Chronic Dis. 2012;9:E82.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Office of Public Health Studies, University of Hawai‘i at Manoa, 1960 East-West Road, Biomed D104-G, Honolulu, HI, 96821, USA

    Tetine Lynn Sentell

  2. Section on Biomarkers and Prediction Modeling, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Chengli Shen & Doug Landsittel

  3. Puerto Rico Clinical and Translational Research Consortium, University of Puerto Rico Medical Sciences Campus, San Juan, PR, USA

    Mary Helen Mays

  4. School of Dentistry, Meharry Medical College, Nashville, TN, USA

    Janet Southerland

  5. Morehouse School of Medicine, Atlanta, GA, USA

    Marshaleen Henriques King

  6. Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, HI, USA

    Deborah A. Taira

Authors
  1. Tetine Lynn Sentell
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  2. Chengli Shen
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  3. Doug Landsittel
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  4. Mary Helen Mays
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  7. Deborah A. Taira
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Corresponding author

Correspondence to Tetine Lynn Sentell.

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Conflict of interest

Tetine Sentell, Chengli Shen, Doug Landsittel, Mary Helen Mays, Janet Southerland, Deborah A. Taira declares that they have no conflict of interest. Marshaleen Henriques King received partial support from the “ENTELLIGENCE Young Investigator Award” funded by Actelion.

Funding

This research was supported by the Expanding National Capacity in Patient Centered Outcomes Research Through Training (ENACT) Program (grant number R25HS023185 from the Agency for Healthcare Research and Quality (AHRQ)) and also from the following National Institutes of Health (NIH) grants: U54MD008149 from the National Institute on Minority Health and Health Disparities (NIMHD); 1U54GM104944 from the National Institute of General Medical Sciences; and P20 MD000173 from NIMHD. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH or AHRQ.

Ethical approval

Because this was a public use data file from the federal government, it did not meet the criteria of human subjects research and was exempt from IRB approval. Thus, this article does not contain any studies with human participants or animals performed by any of the authors.

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Sentell, T.L., Shen, C., Landsittel, D. et al. Racial/Ethnic Differences in Those Accompanying Medicare Patients to the Doctor: Insights from the 2013 Medicare Current Beneficiary’s Survey. J Immigrant Minority Health 20, 776–783 (2018). https://doi.org/10.1007/s10903-017-0582-8

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  • DOI: https://doi.org/10.1007/s10903-017-0582-8

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