If we are going to be successful in improving our healthcare system, we are going to have to make a difference in the quality of healthcare provided, access to care, health literacy on the part of consumers of care; and we will have to make it easier to live a healthier lifestyle for those most at risk. But how can we do this and where do we start?
Any effort that seeks to address healthcare quality and costs, both categories that seem to top the chart for both consumers, payers, political leaders, and policy makers, must address the continuum of prevention, intervention, followup, evaluation, and implementation of findings. The process of true healthcare reform must begin with each individual and the social and economic context in which he or she must navigate (health literacy) to achieve an optimal health lifestyle. The most significant challenge for a culturally diverse society like ours in the area of supporting and addressing lifestyle with the goal of improving health is communication. In the area of healthcare this means optimal interpersonal health communication between provider and service recipient. What do patients who experience communication dissonance in the healthcare encounter think of the physician – patient encounter? That’s where we need to begin.
“Patient-reported experiences of care are an important focus in health disparities research. This study explored the association of patient-reported experiences of care with race and acculturation status in a primary care setting. 881 adult patients (African-American 34%; Hispanic–classified as unacculturated or biculturated–31%; Caucasian 33%; missing race 2%), in outpatient Family Medicine clinics, completed a written survey in Spanish or English. Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group (CAG) Survey Adult Primary Care instrument was used for experiences of care and Short Form-12 survey for health status. Controlling for other variables, race and acculturation were significantly associated with several CAG subscales. Hispanic patients gave significantly higher ratings for care experiences and expressed greater interest in shared decision making. Selected patient-reported measures of care are associated with patients’ race and acculturation status (for Hispanic patients). We discuss implications for both provision and measurement of quality care.”