Abstract：
BACKGROUND: Effective patient-provider communication is a critical component of optimal patient care, but its potential impact on the delivery of healthcare services remains unclear. This study examines the association of patient-provider communication with access to care, healthcare utilization, and financial burden of care.
METHODS: Using the 2013-2021 Medical Expenditure Panel Survey longitudinal data, the level of patient-provider communication was measured across four domains (attentive listening, clear explanation, respectfulness, and time allocation) as a primary independent variable, categorized into low, moderate, and high. A lagged dependent model was employed to examine the associations of patient-provider communication at baseline with subsequent access to care, healthcare utilization, and financial burden of care, controlling for baseline sample characteristics and outcomes measured at the baseline. Analysis was conducted in February 2024.
RESULTS: Among 28,955 analytic samples (representing 709,547,678 U.S. adults), 5.3%, 50.2%, and 44.3% reported low, moderate, and high levels of patient-provider communication. Marginalized populations, including racial/ethnic minorities, those with low education and income, and those lacking insurance, were more likely to report low patient-provider communication. Compared with adults with high patient-provider communication, those with low patient-provider communication were more likely to encounter difficulties in accessing medical care (2.6 percentage points; 95% CI: 1.2-3.9), experience delays in obtaining necessary medical care (2.8 percentage points; 1.3-4.4), have emergency room visits (4.2 percentage points; 1.9-6.4), and face difficulties paying medical bills (4.0 percentage points; 2.2-5.8) in the subsequent year.
CONCLUSIONS: Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities.
METHODS: Using the 2013-2021 Medical Expenditure Panel Survey longitudinal data, the level of patient-provider communication was measured across four domains (attentive listening, clear explanation, respectfulness, and time allocation) as a primary independent variable, categorized into low, moderate, and high. A lagged dependent model was employed to examine the associations of patient-provider communication at baseline with subsequent access to care, healthcare utilization, and financial burden of care, controlling for baseline sample characteristics and outcomes measured at the baseline. Analysis was conducted in February 2024.
RESULTS: Among 28,955 analytic samples (representing 709,547,678 U.S. adults), 5.3%, 50.2%, and 44.3% reported low, moderate, and high levels of patient-provider communication. Marginalized populations, including racial/ethnic minorities, those with low education and income, and those lacking insurance, were more likely to report low patient-provider communication. Compared with adults with high patient-provider communication, those with low patient-provider communication were more likely to encounter difficulties in accessing medical care (2.6 percentage points; 95% CI: 1.2-3.9), experience delays in obtaining necessary medical care (2.8 percentage points; 1.3-4.4), have emergency room visits (4.2 percentage points; 1.9-6.4), and face difficulties paying medical bills (4.0 percentage points; 2.2-5.8) in the subsequent year.
CONCLUSIONS: Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities.
摘要：
背景：有效的患者与提供者沟通是最佳患者护理的关键组成部分，但其对卫生保健服务提供的潜在影响尚不清楚.这项研究检查了患者-提供者沟通与获得护理的关系，医疗保健利用，和护理的经济负担。
方法：使用2013-2021年医疗支出面板调查纵向数据，患者与提供者的沟通水平在四个领域进行了测量(专心倾听，解释清楚,恭敬,和时间分配)作为主要自变量，分类为低，中度,和高。采用滞后依赖模型来检查基线时患者-提供者沟通与后续护理的关联，医疗保健利用，和护理的经济负担，控制基线样本特征和基线测量的结果。2024年2月进行了分析。
结果：在28,955个分析样本（代表709,547,678美国成年人）中，5.3%,50.2%,44.3%的人报告较低，中度,和高水平的患者-提供者沟通。边缘化人口，包括种族/族裔少数，那些教育程度和收入较低的人，那些缺乏保险的人，更有可能报告低患者-提供者沟通。与具有高患者提供者沟通的成年人相比，患者与提供者之间沟通较低的患者在获得医疗护理方面更有可能遇到困难（2.6个百分点；95％CI：1.2-3.9），在获得必要的医疗护理方面经历延误(2.8个百分点；1.3-4.4)，有急诊室就诊(4.2个百分点；1.9-6.4)，并在随后的一年中面临支付医疗费用的困难（4.0个百分点；2.2-5.8）。
结论：鼓励有效的医患沟通对于推进以患者为中心的护理和缓解健康不平等至关重要。
方法：使用2013-2021年医疗支出面板调查纵向数据，患者与提供者的沟通水平在四个领域进行了测量(专心倾听，解释清楚,恭敬,和时间分配)作为主要自变量，分类为低，中度,和高。采用滞后依赖模型来检查基线时患者-提供者沟通与后续护理的关联，医疗保健利用，和护理的经济负担，控制基线样本特征和基线测量的结果。2024年2月进行了分析。
结果：在28,955个分析样本（代表709,547,678美国成年人）中，5.3%,50.2%,44.3%的人报告较低，中度,和高水平的患者-提供者沟通。边缘化人口，包括种族/族裔少数，那些教育程度和收入较低的人，那些缺乏保险的人，更有可能报告低患者-提供者沟通。与具有高患者提供者沟通的成年人相比，患者与提供者之间沟通较低的患者在获得医疗护理方面更有可能遇到困难（2.6个百分点；95％CI：1.2-3.9），在获得必要的医疗护理方面经历延误(2.8个百分点；1.3-4.4)，有急诊室就诊(4.2个百分点；1.9-6.4)，并在随后的一年中面临支付医疗费用的困难（4.0个百分点；2.2-5.8）。
结论：鼓励有效的医患沟通对于推进以患者为中心的护理和缓解健康不平等至关重要。
