Background: Studies report that barriers to the relationship between patients and their healthcare providers contribute to racial disparities in healthcare experience. Although race is thought to play a major role in the disparities seen in patient report on healthcare experience, results reported by different scholars on the effect of race on patient provider communication and overall patient satisfaction has been heterogeneous. In this study, we explore the relationship between patient race/ethnicity and various domains of patient healthcare experience [patient provider communication, shared decision making and overall patient satisfaction] in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD).
Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. We developed a weighted average score for each domain of patient report on healthcare experience, using responses to questions from the CAHPS survey related to patient provider communication, shared decision making and patient overall satisfaction. We compared these scores across patient race/ethnicity.
Results: The proportion of ASCVD patients with an optimal score on all domains of patient reported experience was least among Asians (patient-provider communication 37.5%, shared decision making 36.1%, satisfaction 21.9%, p<0.05). African Americans, Asians and Hispanics were less likely to report optimal patient experience when compared to non-Hispanic whites. Adjustments for covariates yielded mixed results. However, African Americans and Asians were 20% and 39% less likely to be satisfied with their healthcare providers respectively [African Americans (Adjusted OR 0.80, 95% CI 0.67-0.97), Asians (Adjusted OR 0.61, 95% CI 0.39-0.94).
Conclusion: This study reveals a strong relationship between race and patent healthcare experience among individuals with ASCVD. Targeted policies focusing on reducing disparities and improving patient healthcare experience are needed among these vulnerable population.