The influence of institutional factors on patient–provider communication and interactions in the U.S. healthcare system

• Published in: Journal of public health Vol. 31; no. 1; pp. 123 - 134
• Main Authors: Glos, Lukas, Pinet-Peralta, Luis M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2023; Springer Nature B.V
• Subjects: Adults; Communication; Communications systems; Emergency medical care; Emergency medical services; Epidemiology; Health care; Health care facilities; Health Promotion and Disease Prevention; Health services; Indigent care; Medicine; Medicine & Public Health; Organizational aspects; Original Article; Outpatient care facilities; Patients; Physicians; Public Health; Medical Expenditure Panel Survey; Healthcare disparities; Patient–provider communication and interactions; Usual source of care; Primary care
• ISSN: 2198-1833; 1613-2238
• DOI: 10.1007/s10389-020-01426-5

Background Communication and interactions between patients and healthcare providers are important components in the provision of healthcare services. In this study, we assessed the effects of institutional factors, defined as a usual source of care and the type of a usual source of care, on perceived patient–provider communication and interactions. Method We used individual-level data for adults ( N  = 89,725) from the Medical Expenditure Panel Survey for the years 2001 to 2012 and employed multivariate logistic regressions to assess the relationship between institutional factors and four communication and interaction outcomes: provider listened to patient, provider explained so that patient understood, provider showed respect to patient, and provider spent enough time with patient. Results Adults who report having a usual source of care have significantly higher odds of reporting positively on their communication and interactions with their healthcare providers in comparison to adults who do not have a usual source of care. We also find that having an individual physician or nurse practitioner as a usual source of care further improves patient–provider communication and interaction in comparison to having an outpatient clinic, a hospital, an emergency department, or any other type of clinic as a usual source of care. Conclusion Our study shows that having a usual source of care is an important component in patient–provider communication and interactions, beyond patients’ personal characteristics. We also show that having a physician (or any other individual practitioner) rather than a healthcare facility, such as an outpatient clinic, as a usual source of care further improves patient–provider communication and interactions.