Disparities in patient-physician communication for persons with a disability from the 2006 Medical Expenditure Panel Survey (MEPS).
BACKGROUND
Ineffective patient-physician communication has been shown to result in poorer health outcomes for various vulnerable populations. However, little research has been done on patient-physician communication issues as perceived by persons with disabilities. The purposes of this study are to determine if there is a relationship between disability and patient-physician communication and how disability affects the likelihood of effective patient-physician communication. The research questions for this study are: (1) Is there a significant difference in patient-physician communication for persons with disabilities compared to persons without disabilities? (2) Does having a disability influence the likelihood of ineffective patient-physician communication?


METHODS
Data were obtained from the 2006 Medical Expenditure Panel Survey (MEPS). Chi-square analyses were performed to determine if there a significant difference in patient-physician communication for persons with disabilities compared with persons without disabilities. A series of logistic regression analyses were conducted examining the likelihood of ineffective patient-physician communication with the independent variable of disability status.


RESULTS
Those with a disability are significantly more likely than persons without a disability to perceive that the physician does not listen to them, does not explain treatment so that they understand, does not treat them with respect, does not spend enough time with them, and does not involve them in treatment decisions. Regression analyses further revealed that persons with a disability are from 1.36 to 1.78 times as likely to perceive inadequate patient-physician communication.


CONCLUSIONS
This study revealed that persons with disabilities are at increased risk of experiencing ineffective patient-physician communication, compromising current health status and increasing the possibility of secondary health conditions. Several suggestions were made with regard to incorporation of "disability literacy" mechanisms such as physician training, health facility environmental assessment, and use of technologies such as telehealth and e-health. Further research in partnership with the disability community is needed to determine the effectiveness of these methods in improving patient-physician communication.
Department of Occupational Therapy and Occupational Science, University of Missouri, Columbia, MO 65211, USA. smithdiane@health.missouri.edu
Diane L
DL
Smith
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003142:Communication; D006233:Persons with Disabilities; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D055815:Young Adult