The effects of language concordant care on patient satisfaction and clinical understanding for Hispanic pediatric surgery patients

Dunlap, Jonathan L.; Jaramillo, Joshua D.; Koppolu, Raji; Wright, Robert C.; Mendoza, Fernando; Bruzoni, Matías

doi:10.1016/j.jpedsurg.2014.12.020

Cited by 80 publications

(62 citation statements)

References 13 publications

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“…Although these associations were only statistically significant between Asian physician–black or African American patient dyads, these findings are consistent with the previous literature on racial/ethnic concordance between physicians and patients, which has demonstrated that patient satisfaction is greater between racially concordant black or African American physician–patient pairs and Hispanic physician–patient pairs. 13 , 14 , 15 , 16 Thus, whereas the satisfaction scores of black or African American physicians and Hispanic physicians may be improved by interactions with racially concordant patients, the satisfaction scores of Asian physicians are doubly penalized by the greater proportion of Asian patients whom they serve and their discordant racial/ethnic patient interactions. This finding also aligns with the results of a study in which we demonstrated that Asian patients were less likely than white patients to give the most favorable LTR scores even after adjusting for known confounders.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

et al. 2019

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Importance Patient satisfaction scores are used to inform decisions about physician compensation, and there remains a lack of consensus regarding the need to adjust scores for patient race/ethnicity. Previous research suggests that patients prefer physicians of the same race/ethnicity as themselves and that Asian patients provide lower satisfaction scores than non-Hispanic white patients. Objective To examine whether Asian physicians receive less favorable patient satisfaction scores relative to non-Hispanic white physicians. Design, Setting, and Participants This population-based survey study used data from Press Ganey Outpatient Medical Practice Surveys collected from December 1, 2010, to November 30, 2014, which included 149 775 patient survey responses for 962 physicians. Every month, 5 patients per physician were randomly selected to complete a satisfaction survey after an outpatient visit. Hierarchical multivariable logistic regression was used to examine the association between Asian race/ethnicity of the physician and racial/ethnic concordance of the patient with the probability of receiving the highest score on the survey item rating the likelihood to recommend the physician. Statistical analysis was performed from April 2 to August 27, 2018. Exposures Physician characteristics included race/ethnicity, sex, years in practice, and proportion of Asian patient responders. Patient characteristics included race/ethnicity, sex, age, and language spoken. Main Outcomes and Measures The highest score (a score of 5 on a 1-5 Likert scale, where 1 indicates very poor and 5 indicates very good) on the survey item rating the likelihood to recommend the physician on the Press Ganey Outpatient Medical Practice Survey. Results Of the 962 physicians in this study, 515 (53.5%) were women; physicians had a mean (SD) of 19.9 (9.1) years of experience since graduating medical school; 573 (59.6%) were white, and 350 (36.4%) were Asian. In unadjusted analyses, the odds of receiving the highest score on the survey item rating the likelihood to recommend the physician were lower for Asian physicians compared with non-Hispanic white physicians (odds ratio, 0.78; 95% CI, 0.72-0.84; P < .001). This association was not significant after adjusting for patient characteristics, including patient race/ethnicity. However, Asian patients were less likely to give the highest scores relative to non-Hispanic white patients (odds ratio, 0.56; 95% CI, 0.54-0.58; P < .001), regardless of physician race/ethnicity. Conclusions and Relevance This study suggests that Asian physicians may be more likely to receive lower patient satisfaction scores because they serve a greater proportion of Asian patients. Patient satisfaction scores should be adjusted for patient race/ethnicity.

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Section: Discussionmentioning

confidence: 99%

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

et al. 2019

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“…For example, models of care delivery that align Latino patients with linguistically and culturally concordant providers have reported improved satisfaction and understanding. 31,32 Another strategy for improving communication, suggested by Latina mothers, is investing more in relationships with families. 11 Finally, non-physician personnel could be used to address some of the gaps identified in satisfaction for Spanish-speaking Latino parents in this sample, including having as much information as desired, being treated respectfully, and discussing follow-up.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction With Communication in Primary Care for Spanish-Speaking and English-Speaking Parents

Flower

Skinner

Yin

et al. 2017

Academic Pediatrics

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Background and Objective Effective communication with primary care physicians is important yet incompletely understood for Spanish-speaking parents. We predicted lower satisfaction among Spanish-speaking compared with English-speaking Latino and non-Latino parents. Methods Cross-sectional analysis at 2-month well visits within the Greenlight study at 4 pediatric resident clinics. Parents reported satisfaction with 14 physician communication items using the validated Communication Assessment Tool (CAT). High satisfaction was defined as “excellent” on each CAT item. Mean estimations compared satisfaction for communication items among Spanish and English-speaking Latinos and non-Latinos. We used generalized linear regression modeling, adjusted for parent age, education, income, and clinic site. Among Spanish-speaking parents, we compared visits conducted in Spanish with and without an interpreter, and in English. Results Compared with English-speaking Latino (N=127) and non-Latino parents (N=432), fewer Spanish-speaking parents (N=303) reported satisfaction with 14 communication items. No significant differences were found between English-speaking Latinos and non-Latinos. Greatest differences were found in: greeting that made the parent comfortable (59.4% of Spanish-speaking Latinos endorsing “Excellent” vs. 77.5% English-speaking Latinos, p<0.01) and discussing follow-up (62.5% of Spanish-speaking Latinos vs. 79.8% English-speaking Latinos, p<0.01). After adjusting for parent age, education, income, and study site, Spanish-speaking Latinos were still less likely to report high satisfaction with these communication items. Satisfaction was not different among Spanish-speaking parents when the physician spoke Spanish versus used an interpreter. Conclusions Satisfaction with physician communication was associated with language, but not ethnicity. Spanish-speaking parents less frequently report satisfaction with communication, and innovative solutions to enhance communication quality are needed.

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“…Few studies have shown any direct correlation between these 2 variables. The exception is evidence of better outcomes with language concordance between non-English-speaking pairs, [5][6][7][8] although other studies discussed below have reported effects of concordance.…”

Section: Concordance and Health Outcomesmentioning

confidence: 87%

Disentangling Evidence and Preference in Patient-Clinician Concordance Discussions

Rand

Berger

2019

AMA Journal of Ethics

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Debate about whether and when to accommodate patient requests for concordant clinicians should consider evidence. This article examines how existing evidence could be used to interpret or inform ethical arguments about whether to accommodate such requests. Studies on patient-clinician concordance yield mixed and inconclusive results. Concordance might contribute to increased patient satisfaction and trust, but these results are not consistent and could be the result of clinicians' communication skills. Given this evidence and the risk of social harm in honoring concordance requests, this article argues that patients' concordance requests should be honored only when health care services would be denied to a patient, such as in a case of a clinician's conscientious objection to providing a service. All other requests should be scrutinized for a reasonable ethical justification. Concordance Requests In this article, we review evidence about patient-clinician concordance-that is, shared characteristics like gender, race, or socioeconomic status-and discuss how it bears on the debate about whether to accommodate patients' requests for clinicians with specific characteristics. Patients may request a clinician with a specific characteristic for a variety of reasons, including personal preference, religious values, or assumptions about who provides the best care. Some might argue that patients, as the vulnerable party, ought to have their requests accommodated but draw a line when preferences are based on socially unacceptable reasons grounded in prejudice, sexism, or racism.

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The effects of language concordant care on patient satisfaction and clinical understanding for Hispanic pediatric surgery patients

Cited by 80 publications

References 13 publications

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

Comparison of Outpatient Satisfaction Survey Scores for Asian Physicians and Non-Hispanic White Physicians

Satisfaction With Communication in Primary Care for Spanish-Speaking and English-Speaking Parents

Disentangling Evidence and Preference in Patient-Clinician Concordance Discussions

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