Journal of General Internal Medicine

, Volume 14, Issue 7, pp 409–417 | Cite as

Are latinos less satisfied with communication by health care providers?

  • Leo S. Morales
  • William E. Cunningham
  • Julie A. Brown
  • Honghu Liu
  • Ron D. Hays
Original Articles

Abstract

OBJECTIVE: To examine associations of patient ratings of communication by health care providers with patient language (English vs Spanish) and ethnicity (Latino vs white).

METHODS: A random sample of patients receiving medical care from a physician group association concentrated on the West Coast was studied. A total of 7,093 English and Spanish language questionnaires were returned for an overall response rate of 59%. Five questions asking patients to rate communication by their health care providers were examined in this study. All five questions were administered with a 7-point response scale.

MAIN RESULTS: We estimated the associations of satisfaction ratings with language (English vs Spanish) and ethnicity (white vs Latino) using ordinal logistic models, controlling for age and gender. Latinos responding in Spanish (Latino/Spanish) were significantly more dissatisfied compared with Latinos responding in English (Latino/English) and non-Latino whites responding in English (white) when asked about: (1) the medical staff listened to what they say (29% vs 17% vs 13% rated this “very poor,” “poor,” or “fair”; p<.01); (2) answers to their questions (27% vs 16% vs 12%; p<.01); (3) explanations about prescribed medications (22% vs 19% vs 14%; p<.01); (4) explanations about medical procedures and test results (36% vs 21% vs 17%; p<.01); and (5) reassurance and support from their doctors and the office staff (37% vs 23% vs 18%; p<.01).

CONCLUSION: This study documents that Latino/Spanish respondents are significantly more dissatisfied with provider communication than Latino/English and white respondents. These results suggest Spanish-speaking Latinos may be at increased risk of lower quality of care and poor health outcomes. Efforts to improve the quality of communication with Spanish-speaking Latino patients in outpatient health care settings are needed.

Key Words

Hispanic Latino satisfaction communication quality of care 

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References

  1. 1.
    Andersen R, Lewis SZ, Giachello AL, Aday LA, Chiu G. Access to medical care among the Hispanic population of the southwestern United States. J Health Soc Behav. 1981;22(1):78–89.PubMedCrossRefGoogle Scholar
  2. 2.
    Ginzberg E. Access to health care for Hispanics. JAMA. 1991;265(2):238–41.PubMedCrossRefGoogle Scholar
  3. 3.
    Schur CL, White LA, Berk ML. Health care use by Hispanic adults: the role of financial vs non-financial determinants. AHSR FHSR Annu Meet Abstr Book. 1995;12:103. Abstract.Google Scholar
  4. 4.
    Schur CL, Albers LA. Language, sociodemographics, and health care use of Hispanic adults. J Health Care Poor Underserv. 1996;7(2):140–58.Google Scholar
  5. 5.
    Valdez RB, Giachello A, Rodriguez-Trias H, Gomez P, de la Rocha C. Improving access to health care in Latino communities. Public Health Rep. 1993;108(5):534–9.PubMedGoogle Scholar
  6. 6.
    Molina CW, Zambrana RE, Aguirre-Molina M. The influence of culture, class, and environment on health care. In: Molina CW, Aguirre-Molina M, eds. Latino Health in the U.S.: A Growing Challenge. Washington, DC: American Public Health Association; 1997:23–43.Google Scholar
  7. 7.
    Woolley FR, Kane RL, Hughes CC, Wright DD. The effects of doctor-patient communication on satisfaction and outcome of care. Soc Sci Med. 1978;12(2A):123–8.PubMedGoogle Scholar
  8. 8.
    California Cultural Competency Task Force. Recommendations for the Medi-Cal Managed Care Program. Sacramento, Calif: California Department of Health Services; 1994.Google Scholar
  9. 9.
    Lavizzo-Mourey R, Mackenzie ER. Cultural competence: essential measurements of quality for managed care organizations. Ann Intern Med. 1996;124(10):919–21.PubMedGoogle Scholar
  10. 10.
    Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta analysis. Soc Sci Med. 1990;30(7):811–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Harpole LH, Orav EJ, Hickey M, Posther KE, Brennan TA. Patient satisfaction in the ambulatory setting: influence of data collection methods and sociodemographic factors. J Gen Intern Med. 1996;11(7):431–4.PubMedCrossRefGoogle Scholar
  12. 12.
    Baker DW, Parker RM, Williams MV, Coates WC, Pitkin K. Use and effectiveness of interpreters in an emergency department. JAMA. 1996;275(10):783–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Hu DJ, Covell RM. Health care usage by Hispanic outpatients as a function of primary language. West J Med. 1986;144(4):490–3.PubMedGoogle Scholar
  14. 14.
    DiMatteo MR, Hays R. The significance of patients’ perceptions of physician conduct: a study of patient satisfaction in a family practice center. J Commun Health. 1980;6(1):18–34.CrossRefGoogle Scholar
  15. 15.
    Linn LS, Greenfield S. Patient suffering and patient satisfaction among the chronically ill. Med Care. 1982;20(4):425–31.PubMedCrossRefGoogle Scholar
  16. 16.
    Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality care. Inquiry. 1988;25(1):25–36.PubMedGoogle Scholar
  17. 17.
    Aharony L, Strasser S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev. 1993;50(1):49–79.PubMedCrossRefGoogle Scholar
  18. 18.
    Hays RD, Brown JA, Spritzer KL, Dixon WJ, Brook RH. Member ratings of health care provided by 48 physician groups. Arch Intern Med. 1998;158(7):785–90.PubMedCrossRefGoogle Scholar
  19. 19.
    Hays RD, Sherbourne CD, Mazel RM. The RAND 36-Item Health Survey 1.0. Health Econ. 1993;2(3):217–27.PubMedCrossRefGoogle Scholar
  20. 20.
    Angel R, Guarnaccia PJ. Mind, body, and culture: somatization among Hispanics. Soc Sci Med. 1989;28(12):1229–38.PubMedCrossRefGoogle Scholar
  21. 21.
    Hayes RP, Baker DW. Methodological problems in comparing English-speaking and Spanish-speaking patients’ satisfaction with interpersonal aspects of care. Med Care. 1998;36(2):230–6.PubMedCrossRefGoogle Scholar
  22. 22.
    Shetterly SM, Baxter J, Mason LD, Hamman RF. Self-rated health among Hispanic vs non-Hispanic white adults: the San Luis Valley Health and Aging Study. Am J Public Health. 1996;86(12):1798–801.PubMedCrossRefGoogle Scholar
  23. 23.
    DuMouchel WH, Duncan GJ. Using sample survey weights in multiple regression analysis of stratified samples. JASA. 1983;78(383):535–43.Google Scholar
  24. 24.
    Sisk JE, Gorman SA, Reisinger AL, Glied SA, DuMouchel WH, Hynes MM. Evaluation of Medicaid managed care: satisfaction, access, and use. JAMA. 1996;276(1):50–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Todd KH, Samaroo N, Hoffman JR. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA. 1993;269(12):1537–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Perez-Stable EJ, Naapoles-Springer A, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Med Care. 1997;35(12):1212–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Manson A. Language concordance as a determinant of patient compliance and emergency room use in patients with asthma. Med Care. 1988;26:1119–28.PubMedCrossRefGoogle Scholar
  28. 28.
    Rosen K, Sanford S, Scott J. Emergency department care of the Spanish-speaking patient. Ann Emerg Med. 1991;20(466).Google Scholar
  29. 29.
    Hornberger JC, Gibson CD Jr, Wood W, et al. Eliminating language barriers for non-English-speaking patients. Med Care. 1996;34(8):845–56.PubMedCrossRefGoogle Scholar
  30. 30.
    Woloshin S, Bickell NA, Schwartz LM, Gany F, Welch HG. Language barriers in medicine in the United States. JAMA. 1995;273(9):724–8.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 1999

Authors and Affiliations

  • Leo S. Morales
    • 1
    • 3
  • William E. Cunningham
    • 1
    • 2
  • Julie A. Brown
    • 3
  • Honghu Liu
    • 1
  • Ron D. Hays
    • 1
    • 3
  1. 1.Division of General Internal Medicine and Health Services Researchthe University of California Los Angeles, School of MedicineUSA
  2. 2.School of Public HealthLos Angeles
  3. 3.RANDSanta Monica

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