title: Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey.
abstract: 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.
  
  
  OBJECTIVE
  To determine how reported GP-patient communication varies between patients from different ethnic groups, stratified by age and gender.
  
  
  METHODS
  Analysis of data from the English GP Patient Survey from 2012-2013 and 2013-2014, including 1,599,801 responders.
  
  
  METHODS
  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'.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge.
authors.forename: Jenni
authors.initials: J
authors.lastname: Burt
authors.affiliation: Faculty of Health and Social Care, The Open University, Milton Keynes.
authors.forename: Cathy
authors.initials: C
authors.lastname: Lloyd
authors.affiliation: University of Exeter Collaboration for Academic Primary Care, University of Exeter Medical School, Exeter.
authors.forename: John
authors.initials: J
authors.lastname: Campbell
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge.
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge.
authors.forename: Gary
authors.initials: G
authors.lastname: Abel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005006:Ethnicity; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations / Q000941:ethics*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D006113:United Kingdom
keywords: communication; healthcare disparities; minority groups; physician–patient relations; primary health care