Perceptions of Patient-Provider Communication Across the Six Largest Asian Subgroups in the USA

J Gen Intern Med. 2021 Apr;36(4):888-893. doi: 10.1007/s11606-020-06391-z. Epub 2021 Feb 9.


Background: Asians are the fastest-growing racial/ethnic minority group in the USA and many face communication barriers when seeking health care. Given that a high proportion of Asians are immigrants and have limited English proficiency, poor patient-provider communication may explain Asians' relatively low ratings of care. Though Asians are linguistically, economically, and culturally heterogeneous, research on health care disparities typically combines Asians into a single racial/ethnic category.

Objectives: To estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups.

Design and participants: Using a nationally representative sample of adults from the 2014-2017 Medical Expenditure Panel Survey (N = 136,836, round-specific response rates range from 72% to 98%), we estimate racial/ethnic differences in perceptions of provider communication, adjusted for English proficiency, immigration status, and sociodemographic characteristics.

Main measures: The main dependent variable is a 4-item scale ranging from 0 to 100 measuring how positively patients view their health care providers' communication, adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS©) program. Respondents report how often their providers explain things clearly, show respect, listen carefully, and spend enough time with them.

Key results: Asians, overall, had less positive perceptions of their providers' communication than either Whites or Latinxs. However, only Chinese-White differences remained after differences in English proficiency and immigration status were controlled (difference = - 2.67, 95% CI - 4.83, - 0.51). No other Asian subgroup differed significantly from Whites.

Conclusions: Negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. Researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care should, if possible, avoid categorizing all Asians into a single group.

Keywords: health care quality; patient-provider communication; racial/ethnic disparities.

MeSH terms

  • Adult
  • Asian
  • Asian People
  • Communication
  • Communication Barriers
  • Ethnicity*
  • Humans
  • Minority Groups*
  • Perception
  • United States