Patient-provider communication quality for persons with disabilities: A cross-sectional analysis of the Health Information National Trends Survey

Nicole M Marlow; Shenae K Samuels; Ara Jo; Arch G Mainous 3rd

doi:10.1016/j.dhjo.2019.03.010

Patient-provider communication quality for persons with disabilities: A cross-sectional analysis of the Health Information National Trends Survey

Disabil Health J. 2019 Oct;12(4):732-737. doi: 10.1016/j.dhjo.2019.03.010. Epub 2019 Apr 4.

Authors

Nicole M Marlow¹, Shenae K Samuels², Ara Jo³, Arch G Mainous 3rd³

Affiliations

¹ Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. Electronic address: marlownm@phhp.ufl.edu.
² Office of Human Research, Memorial Healthcare System, Hollywood, FL, USA.
³ Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.

PMID: 30995967
DOI: 10.1016/j.dhjo.2019.03.010

Abstract

Background: It is unclear how perceived patient-provider communication quality (PPPCQ) varies according to disability status. Lack of adequate patient-provider communication may prevent providers from considering healthcare issues that are relevant and important to persons with disabilities (PWD), potentially contributing to poorer health outcomes.

Objective/hypothesis: To examine PPPCQ by disability status using current U.S. Department of Health and Human Services standards for surveillance of functional disabilities.

Methods: This cross-sectional study used nationally-representative data from the 2012-2013 Health Information National Trends Survey (HINTS). Participants were categorized as having any disability (hearing, vision, mobility, cognitive, self-care, and/or independent living limitations). PPPCQ was assessed using seven HINTS questions about communication with healthcare professionals. Linear regression was used to estimate mean differences in composite PPPCQ scores, and logistic regression was used to estimate odds ratios (OR) for a provider "always or usually" performing PPPCQ.

Results: The study population comprised 5301 participants, representing 180,442,731 U.S. adults. Overall, 22.1% (weighted) reported any disability. Adjusted mean PPPCQ scores were significantly lower for PWD (72.8, 95% CI: 68.2-77.4) than persons without disability (78.3, 95% CI: 76.5-80.2), p = 0.021. More specifically, PWD were significantly less likely to be given attention needed to address feelings and emotions (OR = 0.6, 95% CI: 0.4, 0.9, p = 0.017), to have next steps understood (OR = 0.4, 95% CI: 0.2, 0.8, p = 0.019), and to receive a clear explanation (OR = 0.3, 95% CI: 0.1, 0.8, p = 0.018).

Conclusions: PWD are less likely to report key elements of effective patient-provider communication. Implementing patient-centered care may improve patient-provider communication for this vulnerable population.

Keywords: Healthcare quality; Patient-provider communication; Persons with disabilities.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Adult
Aged
Communication*
Cross-Sectional Studies
Delivery of Health Care
Disabled Persons*
Female
Health Personnel
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Patient-Centered Care
Physician-Patient Relations*
Surveys and Questionnaires
United States
Young Adult