Favorable ratings of providers' communication behaviors among U.S. women with depression: a population-based study applying the behavioral model of health services use

Abstract

Background: Little is known about the relationships between sociodemographic characteristics and ratings of provider communication behavior among women with depression in the United States. This study uses the Andersen Behavioral Model to examine the relationships among predisposing, enabling, and need factors and ratings of perceived patient-provider communication in women with depression.

Methods: The sample consisted of women with depression who visited any provider in the previous 12 months in the 2002-2008 Medical Expenditure Panel Survey (n = 3,179; weighted n = 4,707,255). Multivariate logistic regression was used to examine the independent contribution of predisposing, enabling, and need factors on providers' communication behavior measures.

Findings: Black (non-Hispanic) women were more likely to report that providers always listened carefully (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.01-1.94), explained so they understood (OR, 1.53; 95% CI, 1.10-2.11), and showed respect for what they had to say (OR, 1.39; 95% CI, 1.01-1.92). Women participating in the paid workforce and those without a usual source of care were at increased risk for less favorable experiences.

Conclusions: Participation in the paid workforce and lack of a usual source of care were associated with an increased likelihood of less optimal communication experiences.

Implications for practice and/or policy: Ensuring that women with depression have reliable access to a continuous source of care and expanding the availability of nonemergent, after-hours care may be instrumental for improving patient-provider communication in this population.