title: Patient-physician social concordance, medical visit communication and patients' perceptions of health care quality.
abstract: Social characteristics (e.g. race, gender, age, education) are associated with health care disparities. We introduce social concordance, a composite measure of shared social characteristics between patients and physicians.
  
  
  OBJECTIVE
  To determine whether social concordance predicts differences in medical visit communication and patients' perceptions of care.
  
  
  METHODS
  Regression analyses were used to determine the association of patient-provider social concordance with medical visit communication and patients' perceptions of care using data from two observational studies involving 64 primary care physicians and 489 of their patients from the Baltimore, MD/Washington, DC/Northern Virginia area.
  
  
  RESULTS
  Lower patient-physician social concordance was associated with less positive patient perceptions of care and lower positive patient affect. Patient-physician dyads with low vs. high social concordance reported lower ratings of global satisfaction with office visits (OR=0.64 vs. OR=1.37, p=0.036) and were less likely to recommend their physician to a friend (OR=0.61 vs. OR=1.37, p=0.035). A graded-response was observed for social concordance with patient positive affect and patient perceptions of care.
  
  
  CONCLUSIONS
  Patient-physician concordance across multiple social characteristics may have cumulative effects on patient-physician communication and perceptions of care.
  
  
  CONCLUSIONS
  Research should move beyond one-dimensional measures of patient-physician concordance to understand how multiple social characteristics influence health care quality.
authors.affiliation: Johns Hopkins Bayview Medical Center Department of Pediatrics and Neonatology, Baltimore, MD, USA. rjohns21@jhmi.edu
authors.forename: Rachel L Johnson
authors.initials: RL
authors.lastname: Thornton
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D004219:District of Columbia; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009819:Office Visits; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012044:Regression Analysis; D012737:Sex Factors; D012933:Social Identification; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014768:Virginia