The influence of patient-provider communication quality on ratings of healthcare, self-efficacy, and care management among non-pregnant women of childbearing age with diabetes mellitus in the United States

Abstract

Objectives To determine associations between patient-provider communication (PPC) quality and ratings of health care received, self-efficacy, and management adherence among non-pregnant reproductive-age women with diabetes. Methods Longitudinal data from the 2012–2018 Medical Expenditure Panel Survey were analyzed. The sample included women of childbearing age (18–45 years) with diabetes (n = 493). Associations between PPC quality and overall health care rating, self-efficacy, and management adherence (eye exam, foot exam, flu vaccine, blood cholesterol, HbA1c) were evaluated before and after adjusting for age, race/ethnicity, marital status, education, poverty level, insurance, and perceived health status. Optimal PPC quality was measured by women’s report of whether or not their health care provider always listened, explained things, showed respect, spent enough time, gave specific instructions and demonstrated health literate practices (clear instructions and asking them to “teach-back” how they will follow instructions). Results Diabetes management adherence was significantly greater among women who reported receiving optimal PPC quality compared to those who did not (OR = 2.02; 95% CI = 1.09–3.76) after adjusting for covariates. There were no statistically significant differences in ratings of health care or diabetes care self-efficacy by PPC quality. Conclusions for Practice: Results demonstrate that non-pregnant women of childbearing age with diabetes who report optimal PPC quality have increased likelihood of diabetes care management adherence. This finding underlines the importance of providing training in communication-centered skills, which should be regularly implemented during healthcare encounters for women with diabetes, particularly for those at increased risk of poorer health outcomes due to and structural barriers to quality health care.