Journal of Gastrointestinal Surgery

, Volume 22, Issue 4, pp 624–632 | Cite as

Patient-Provider Communication and Health Outcomes Among Individuals with Hepato-Pancreato-Biliary Disease in the USA

  • Qinyu Chen
  • Eliza W. Beal
  • Eric B. Schneider
  • Victor Okunrintemi
  • Xu-feng Zhang
  • Timothy M. Pawlik
Original Article



Patient-provider communication (PPC) is utilized as a value-based metric in pay-for-performance programs. We sought to evaluate the association of PPC with patient-reported health outcomes, as well as healthcare resource utilization among a nationally representative cohort of patients with hepato-pancreato-biliary (HPB) diagnoses.


Patients with HPB diseases were identified from the 2008–2014 Medical Expenditure Panel Survey cohort. A weighted PPC composite score was categorized using the responses from the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey as optimal, average, or poor. Multivariate analysis was performed using logistic regression.


Among 1951 adult-patients, representing 21.7 million HPB patients, reported PPC was optimal (33.4%), average (46.3%), or poor (15.3%). Patients who were older and patients with low income were more likely to report poor PPC (both p < 0.05). Statin use, a quality of care measure, was associated with optimal PPC (OR 1.70, 95% CI 1.10–2.64; p = 0.01). In contrast, patients who reported poor PPC were more likely to have a poor physical (20.8%) or mental (8.8%) health component on their SF12 (both p < 0.05). Furthermore, patients with poor PPC were more likely to report poor mental status (OR 2.97, 95% CI 1.60–5.52), as well as higher emergency department visits (OR 1.95, 95% CI 1.25–3.05) and hospitalizations (OR 1.90, 95% CI 1.02–3.55) (both p < 0.05). Reported PPC was not associated with differences in overall healthcare expenditures or out-of-pocket expenditures.


PPC was associated with a wide spectrum of patient-specific demographic and health utilization factors. Self-reported patient satisfaction with provider communication may be impacted by other considerations than simply the patient-provider interaction.


Patient-provider communication HPB disease Health outcomes Hospital utilization Quality of care measures 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

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  1. 1.
    Handy CM, O’Dea D. Site-specific cancer series: pancreatic and hepatobiliary cancers. 2013:124.Google Scholar
  2. 2.
    Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. British Journal of Surgery. 2006;93(1):67–72.CrossRefPubMedGoogle Scholar
  3. 3.
    De Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. New England Journal of Medicine. 1999;341(18):1368–78.CrossRefPubMedGoogle Scholar
  4. 4.
    Bartley KB, Haney R. Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases. Journal of Cardiovascular Nursing. 2010;25(1):13–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open. 2013;3(1):e001570.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Taylor K. Paternalism, participation and partnership—the evolution of patient centeredness in the consultation. Patient education and counseling. 2009;74(2):150–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Wright MT. Patient–Provider Communication. Encyclopedia of Aging and Public Health. 2008, pp 631–3.Google Scholar
  8. 8.
    Okunrintemi V, Spatz ES, Di Capua P, Salami JA, Valero-Elizondo J, Warraich H, Virani SS, Blaha MJ, Blankstein R, Butt AA, Borden WB. Patient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States. Circulation: Cardiovascular Quality and Outcomes. 2017;10(4):e003635.Google Scholar
  9. 9.
    Zullig LL, Shaw RJ, Shah BR, Peterson ED, Lindquist JH, Crowley MJ, Grambow SC, Bosworth HB. Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population. Patient preference and adherence. 2015;9:311.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Bertakis KD, Azari R. Patient-centered care is associated with decreased health care utilization. The Journal of the American Board of Family Medicine. 2011;24(3):229–39.CrossRefPubMedGoogle Scholar
  11. 11.
    Janisse T. Relationship of a Physician’s Well-Being to Interactions with Patients: Practices of the Highest Performing Physicians on the Art of Medicine Patient Survey. The Permanente Journal. 2008;12(4):70.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Agency for Healthcare Research and Quality. Medical Expenditure Panel Survey: Survey Background. Accessed February 2, 2017.
  13. 13.
    Lyles CR, Sarkar U, Ralston JD, Adler N, Schillinger D, Moffet HH, Huang ES, Karter AJ. Patient–provider communication and trust in relation to use of an online patient portal among diabetes patients: The Diabetes and Aging Study. Journal of the American Medical Informatics Association. 2013;20(6):1128–31.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ankersen DV, Weimers P, Burisch J. Whats ‘App-ening’: the help of new technologies in nutrition in digestive diseases. Current Opinion in Clinical Nutrition & Metabolic Care. 2017;20(5):426–31.CrossRefGoogle Scholar
  15. 15.
    Nouri SS, Rudd RE. Health literacy in the “oral exchange”: An important element of patient–provider communication. Patient education and counseling. 2015;98(5):565–71.CrossRefPubMedGoogle Scholar
  16. 16.
    Ye J, Rust G, Fry-Johnson Y, Strothers H. E-mail in patient–provider communication: A systematic review. Patient education and counseling. 2010;80(2):266–73.CrossRefPubMedGoogle Scholar
  17. 17.
    Zickmund SL, Hess R, Bryce CL, McTigue K, Olshansky E, Fitzgerald K, Fischer GS. Interest in the use of computerized patient portals: role of the provider–patient relationship. Journal of general internal medicine. 2008;23(1):20–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Williams MV, Davis T, Parker RM, Weiss BD. The role of health literacy in patient-physician communication. FAMILY MEDICINE-KANSAS CITY-. 2002;34(5):383–9.Google Scholar
  19. 19.
    Song L, Weaver MA, Chen RC, Bensen JT, Fontham E, Mohler JL, Mishel M, Godley PA, Sleath B. Associations between patient–provider communication and socio-cultural factors in prostate cancer patients: A cross-sectional evaluation of racial differences. Patient education and counseling. 2014;97(3):339–46.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Cooper-Patrick L, Gallo JJ, Gonzales JJ, Vu HT, Powe NR, Nelson C, Ford DE. Race, gender, and partnership in the patient-physician relationship. Jama. 1999;282(6):583–9.CrossRefPubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2017

Authors and Affiliations

  • Qinyu Chen
    • 1
  • Eliza W. Beal
    • 1
  • Eric B. Schneider
    • 1
  • Victor Okunrintemi
    • 2
  • Xu-feng Zhang
    • 1
    • 3
  • Timothy M. Pawlik
    • 1
  1. 1.Department of SurgeryThe Ohio State University Wexner Medical CenterColumbusUSA
  2. 2.Center for Healthcare Advancement and Outcomes, Miami Cardiac and Vascular InstituteBaptist Health South FloridaMiamiUSA
  3. 3.Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and EngineeringThe First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina

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