gp患者沟通的种族、年龄和性别差异:来自全国初级保健患者调查的证据

J. Burt, C. Lloyd, John Campbell, M. Roland, G. Abel
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引用次数: 41

摘要

医患沟通是初级保健整体满意度的关键驱动因素。来自少数民族背景的患者一致报告了更多的负面医患沟通经历。然而,目前尚不清楚这些种族差异是集中在一种性别还是集中在特定年龄组。目的了解不同种族、不同年龄、不同性别患者间gp -患者沟通的差异。设计与设置分析2012-2013年和2013-2014年英国全科医生患者调查数据,包括1599 801名应答者。方法从涉及护理人际方面的5个调查项目中对医患沟通进行综合评分。使用混合效应线性回归模型来估计英国白人患者与其他种族相同年龄和性别的患者之间的年龄和性别差异。结果强有力的证据表明,种族对gp患者沟通的影响随年龄和性别的变化而变化(按性别按年龄的三方交互项P<0.001)。在医患沟通项目上,英国白人和其他应答者的得分差异最大的是年龄较大的、巴基斯坦女性和孟加拉国应答者,以及将自己的种族描述为“任何其他白人”的年轻应答者。在gp患者沟通经验方面存在显著差异的群体(老年、女性、亚洲患者和年轻的“任何其他白人”患者)的识别,强调了对这些群体的护理质量的重新关注的必要性。
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Variations in GP–patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey
Background Doctor–patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor–patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. Aim To determine how reported GP–patient communication varies between patients from different ethnic groups, stratified by age and gender. Design and setting Analysis of data from the English GP Patient Survey from 2012–2013 and 2013–2014, including 1 599 801 responders. Method A composite score was created for doctor–patient communication from five survey items concerned with interpersonal aspects of care. Mixed-effect linear regression models were used to estimate age- and gender-specific differences between white British patients and patients of the same age and gender from each other ethnic group. Results There was strong evidence (P<0.001 for age by gender by ethnicity three-way interaction term) that the effect of ethnicity on reported GP–patient communication varied by both age and gender. The difference in scores between white British and other responders on doctor–patient communication items was largest for older, female Pakistani and Bangladeshi responders, and for younger responders who described their ethnicity as ‘Any other white’. Conclusion The identification of groups with particularly marked differences in experience of GP–patient communication — older, female, Asian patients and younger ‘Any other white’ patients — underlines the need for a renewed focus on quality of care for these groups.
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