title: Language spoken at home and the association between ethnicity and doctor-patient communication in primary care: analysis of survey data for South Asian and White British patients.
abstract: OBJECTIVE
  To investigate if language spoken at home mediates the relationship between ethnicity and doctor-patient communication for South Asian and White British patients.
  
  
  METHODS
  We conducted secondary analysis of patient experience survey data collected from 5870 patients across 25 English general practices. Mixed effect linear regression estimated the difference in composite general practitioner-patient communication scores between White British and South Asian patients, controlling for practice, patient demographics and patient language.
  
  
  RESULTS
  There was strong evidence of an association between doctor-patient communication scores and ethnicity. South Asian patients reported scores averaging 3.0 percentage points lower (scale of 0-100) than White British patients (95% CI -4.9 to -1.1, p=0.002). This difference reduced to 1.4 points (95% CI -3.1 to 0.4) after accounting for speaking a non-English language at home; respondents who spoke a non-English language at home reported lower scores than English-speakers (adjusted difference 3.3 points, 95% CI -6.4 to -0.2).
  
  
  CONCLUSIONS
  South Asian patients rate communication lower than White British patients within the same practices and with similar demographics. Our analysis further shows that this disparity is largely mediated by language.
authors.affiliation: University of California Davis School of Medicine, Sacramento, California, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Brodie
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Abel
authors.affiliation: Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors.forename: Jenni
authors.identifier: http://orcid.org/0000-0002-0037-274X
authors.initials: J
authors.lastname: Burt
mesh_terms: D000328:Adult; D044466:Asian People; D003142:Communication; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007802:Language; D008297:Male; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D044465:White People
keywords: MEDICAL EDUCATION & TRAINING; PRIMARY CARE