Patient-Physician Communication Experience Modifies Racial/Ethnic Health Care Disparities Among Surveillance, Epidemiology, and End Results-Consumer Assessment of Healthcare Providers and Systems Participants With Colorectal Cancer and Multiple Chronic Conditions

被引：0

作者：

Navarro, Stephanie ^{[1
]}

Le, Jessica ^{[2
]}

Tsui, Jennifer ^{[1
,3
]}

Barzi, Afsaneh ^{[4
]}

Stern, Mariana C. ^{[1
,3
]}

Pickering, Trevor ^{[1
]}

Farias, Albert J. ^{[1
,3
]}

机构：

[1] USC, Dept Populat & Publ Hlth Sci, Keck Sch Med, Los Angeles, CA USA

[2] USC, Keck Sch Med, Los Angeles, CA USA

[3] USC, Norris Comprehens Canc Ctr, Los Angeles, CA USA

[4] City Hope Comprehens Canc Ctr, Duarte, CA USA

来源：

MEDICAL CARE | 2025年 / 63卷 / 03期

关键词：

patient-provider communication; racial/ethnic disparities; multimorbidity; chronic conditions in cancer; QUALITY-OF-CARE; OLDER-ADULTS; PSYCHOMETRIC PROPERTIES; PREVENTIVE CARE; MEDICAL-CARE; ASSOCIATION; SURVIVORS; ACCESS; PERCEPTIONS; AMERICAN;

D O I：

10.1097/MLR.0000000000002112

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Purpose:After cancer diagnosis, non-White patients and those with multimorbidity use less primary care and more acute care than non-Hispanic White (NHW) patients and those lacking comorbidities. Yet, positive patient experiences with physician communication (PC) are associated with more appropriate health care use. In a multimorbid cohort, we measured associations between PC experience, race and ethnicity, and health care use following colorectal cancer (CRC) diagnosis.Participants and Methods:We identified 2606 participants using Surveillance, Epidemiology, and End Results (SEER)-Consumer Assessment of Health Care Providers and Systems (CAHPS) data who were diagnosed with CRC from 2001 to 2017 with pre-existing chronic conditions. Self-reported PC experiences were derived from Medicare CAHPS surveys. Chronic condition care, emergency department, and hospital use following CRC diagnosis were identified from Medicare claims. Simple survey-weighted multivariable logistic regression stratified by experiences with care analyzed associations between race and ethnicity and health care use.Results:Among patients reporting excellent PC experience, non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian (NHA) patients were more likely to use sufficient chronic condition care than NHW patients (NHB: OR=1.48, 99.38% CI=1.38-1.58; Hispanic: OR=1.34, 99.38% CI=1.26-1.42; NHA: OR=2.31, 99.38% CI=2.12-2.51). NHB and NHA patients were less likely than NHW patients to visit the emergency department when reporting excellent PC experience (NHB: OR=0.66, 99.38% CI=0.63-0.69; NHA: OR=0.67, 99.38% CI=0.64-0.71). Among patients reporting excellent PC, NHB, Hispanic, and NHA patients were less likely than NHW patients to be hospitalized (NHB: OR=0.93, 99.38% CI=0.87-0.99; Hispanic: OR=0.93, 99.38% CI=0.87-0.99; NHA: OR=0.20, 99.38% CI=0.19-0.22).Conclusion:Improving patient experiences with PC, particularly among older racial and ethnic minority cancer survivors with chronic conditions, may help reduce disparities in adverse healthcare use following CRC diagnosis.

引用

页码：256 / 265

页数：10

共 1 条

[1] Patient Experience and Clinical Outcomes in Urologic Cancers: A Surveillance, Epidemiology, and End Results and Consumer Assessment of Healthcare Providers and Systems Study
Mohan, Charan S.
Rotter, Jason S.
Nielsen, Matthew E.
Pruthi, Raj S.
Wallen, Eric M.
Tan, Hung-Jui
Smith, Angela B.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2019, 229 (04) : S319 - S320

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