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
  • 109 Downloads

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

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

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

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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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