National Healthcare Disparities Report - LDI Health Economist

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Patient Centeredness Figure 5.5. Adult hospital patients who reported poor communication with nurses and with doctors, by race, ethnicity, education, and language, 2008 10 Communication With Nurses 8 Chapter 5 Percent 6 4 2 0 White Black Asian NHOPI AI/AN >1 Race Non-Hispanic White Hispanic < High School High School Grad Any College English at Home Spanish at Home Other Language 10 Communication With Doctors 8 Percent 6 4 2 0 White Black Asian NHOPI AI/AN >1 Race Non-Hispanic White Hispanic < High School High School Grad Any College English at Home Spanish at Home Other Language Key: NHOPI = Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native. Source: Agency for Healthcare Research and Quality, Hospital CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Survey, 2008. Note: For this measure, lower rates are better. Poor communication is defined as responded “sometimes” or “never” to the set of survey questions: “During this hospital stay, how often did doctors/nurses treat you with courtesy and respect” “During this hospital stay, how often did doctors/nurses listen carefully to you” and “During this hospital stay, how often did doctors/nurses explain things in a way you could understand” 170 National Healthcare Quality Report, 2011
Patient Centeredness n In 2008, overall, 6% of adult hospital patients reported poor communication with nurses during their hospital stay, and 5% reported poor communication with doctors (data not shown). n Compared with Whites, all minority groups were more likely to report poor communication with nurses (Figure 5.5). Blacks, American Indians and Alaska Natives, and patients of more than one race were more likely to report poor communication with doctors. n Also in 2008, Hispanics were less likely to report poor communication with nurses but not with doctors compared with non-Hispanic Whites (5% compared with 7% with nurses). n Patients with less than a high school education were more likely to report poor communication with both nurses and doctors compared with patients with any college education (7% compared with 5% with nurses, 6% compared with 5% with doctors, respectively). n Patients who speak Spanish at home were more likely to report poor communication with nurses compared with patients who speak English at home (7% and 5%, respectively), while patients who speak some other language at home were more likely to report poor communication with both nurses and doctors (7% for nurses and 6% for doctors). Also, in the NHQR: Chapter 5 n Patients ages 45-64 were more likely to report poor communication with doctors compared with patients ages 18-44. n Patients age 65 and over were less likely to report poor communication with nurses compared with patients ages 18-44. Patient and Family Engagement: Enabling Effective Patient Navigation and Management of Care To effectively navigate the complicated health care system, health care providers need to give patients access to culturally and linguistically appropriate tools to support patient engagement. Culturally and linguistically appropriate services (CLAS) are important components of effective health care delivery. It is vital for providers to understand patients’ health care needs and for patients to understand providers’ diagnoses and treatment recommendations. Communication barriers can relate to language, culture, and health literacy. This year, we provide data on language diversity. For people with limited English proficiency, having language assistance is of particular importance, so they may choose a usual source of care in part based on language concordance. Not having a language-concordant provider may limit or discourage some patients from establishing a usual source of care. To fill the data gap that currently exists, we examined subnational data-gathering activities and identified the California Health Interview Survey (CHIS) as a unique source of this type of information. CHIS is conducted by the UCLA Center for Health Policy Research in collaboration with the California Department of Public Health, the Department of Health Care Services, and the Public Health Institute. Every 2 years, CHIS involves random-dial telephone interviews with up to 50,000 California households. The people included in CHIS are a statistically representative sample of the entire State’s diverse population. With each survey cycle, new households are selected to participate. Beginning in 2007, CHIS also includes a sample of cell-phone-only households, which are often younger and more mobile Californians frequently overlooked in land-line surveys. National Healthcare Quality Report, 2011 171
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