Chapter 5. Patient Centeredness (Text Descriptions)

National Healthcare Disparities Report, 2011


Figure 5.1. Adults who had a doctor's office or clinic visit in the last 12 months who reported poor communication with health providers, by race and by education, 2002-2008

Race2002200320042005200620072008
White (percent)10.49.49.09.19.59.09.0
Black (percent)11.411.311.312.710.310.412.2
Asian (percent)14.513.514.313.013.110.911.1
AI/AN (percent)18.48.3--15.6--
Multiple (percent)13.815.214.49.714.315.012.3

Education2002200320042005200620072008
Any College (percent)9.78.88.48.58.68.78.2
High School Grad (percent)10.99.69.99.510.68.910.3
<High School (percent)13.413.012.813.512.411.612.5

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008.

Denominator: Civilian noninstitutionalized population age 18 and over who had a doctor's office or clinic visit in the last 12 months.

Note: For this measure, lower rates are better. Patients who report that their health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.

Footnote: - = no data value available.

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Figure 5.2. Adult ambulatory patients who reported poor communication with health providers, by race and ethnicity, stratified by income, 2008

IncomeWhiteBlackAsian
Poor13.117.1-
Low Income11.912.3-
Middle Income9.312.311.5
High Income7.18.19.5

IncomeNon-Hispanic WhiteHispanic
Poor (percent)13.411.9
Low Income (percent)11.115.3
Middle Income (percent)9.210.7
High Income (percent)7.25.6

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2008.

Denominator: Civilian noninstitutionalized population age 18 and over.

Note: For this measure, lower rates are better. Sample sizes were too small to provide estimates for poor and near-poor Asians. Patients who report that their health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.

Footnote: - = no data value available.

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Figure 5.3. Children who had a doctor's office or clinic visit in the last 12 months whose parents reported poor communication with health providers: Overall composite, by race and insurance status, 2002-2008

Race2002200320042005200620072008
White (percent)6.55.55.45.34.94.84.4
Black (percent)7.17.56.35.75.15.14.1
Asian (percent)10.212.57.6-3.5-3.8
Multiple Race (percent)10.16.77.96.7-4.75.3

Race2002200320042005200620072008
White (percent)10.49.49.09.19.59.09.0
Black (percent)11.411.311.312.710.310.412.2
Asian (percent)14.513.514.313.013.110.911.1
AI/AN (percent)18.48.3--15.6--
Multiple (percent)13.815.214.49.714.315.012.3

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008.

Denominator: Civilian noninstitutionalized population under age 18.

Note: For this measure, lower rates are better. Data for Asians in 2005 and 2007 and multiple-race children in 2006 did not meet criteria for statistical reliability. Parents who report that their child's health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.

Footnote: - = no data value available.

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Figure 5.4. Composite measure: Children with ambulatory visits whose parents reported poor communication with health providers, by race and ethnicity, stratified by income, 2008

IncomeWhiteBlack
Poor (percent)6.76.0
Low Income (percent)5.93.7
Middle (percent)3.13.5
High (percent)3.9-

IncomeNon-Hispanic WhiteHispanic All Races
Poor (percent)7.56.0
Low Income (percent)4.88.2
Middle (percent)2.93.8
High (percent)3.83.7

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2008.

Denominator: Civilian noninstitutionalized population under age 18.

Note: For this measure, lower rates are better. Data were not available for high-income Blacks. Parents who report that their child's health providers sometimes or never listened carefully, explained things clearly, showed respect for what they had to say, or spent enough time with them are considered to have poor communication.

Footnote: - = no data value available.

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Figure 5.5. Adult hospital patients who reported poor communication with nurses and with doctors, by race, ethnicity, education, and language, 2008

Communication With NursesPercent
White5.3
Black7.5
Asian6.4
NHOPI6.7
AI/AN8.0
>1 Race7.8
Non-Hispanic White6.5
Hispanic5.3
<High School6.5
High School Grad5.3
Any College5.2
English at Home5.4
Spanish at Home6.9
Other Language7.2

Communication With DoctorsPercent
White4.9
Black5.9
Asian5.2
NHOPI5.4
AIAN7.2
>1 Race7.6
Non-Hispanic White4.9
Hispanic5.1
<High School5.7
High School Grad5.0
Any College5.0
English at Home5.2
Spanish at Home4.8
Other Language5.9

Key: NHOPI - Native Hawaiian or Other Pacific Islander; AI/AN = American Indian or Alaska Native.

Source: Agency for Healthcare Research and Quality, Hospital CAHPS ® (Consumer Assessment of Healthcare Providers and Systems) Survey, 2008.

Note: For this measure, lower rates are better. Poor communication is defined as responded "sometimes" or "never" to the set of survey questions: "During this hospital stay, how often did doctors/nurses treat you with courtesy and respect?" "During this hospital stay, how often did doctors/nurses listen carefully to you?" and "During this hospital stay, how often did doctors/nurses explain things in a way you could understand?"

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Figure 5.6. California and New Jersey Hospitals with a high number of discharges when English was not the primary language, by ownership, teaching status, occupancy load, and geographic location, 2009

HospitalsPrivate For ProfitPrivate Not for ProfitPublicTeachingNonteachingHigh OccupancyMed OccupancyLow OccupancyLarge MetroSmall MetroMicropolitanNoncore
Hospitals with High numbers of Non-English Speakers92.690.684.376.694.582.192.597.486.995.9100.0100.0
Hospitals with Low numbers of Non-English Speakers7.49.415.723.45.517.97.52.613.14.100

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases.

Note: n=42 hospitals; n=229,394 discharges. High Percentage Spanish Hospitals represent the top 10% of facilities with the highest percentages of discharges for where English was not the primary language. California and New Jersey only.

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Figure 5.7. Adults with limited English proficiency, by whether they had a usual source of care with or without language assistance, by race, ethnicity, income, and education, 2008

Race / Ethnicity / Income / EducationNo USCWith Language AssistanceWithout Language Assistance
White (percent)52.544.03.5
Black (percent)39.945.015.0
Asian (percent)42.834.922.4
Non-Hispanic (percent)41.141.917.0
Hispanic (percent)53.244.32.5
Poor (percent)45.449.6-
Poor (percent)52.642.64.8
Low Income (percent)56.239.93.9
Middle Income (percent)48.245.76.1
<High School (percent)50.146.03.9
High School Grad (percent)53.838.97.3
Any College (percent)46.445.08.6

Key: USC = usual source of care.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2008.

Note: For this measure, lower rates are better. Hispanic and non-Hispanic include all races. Data were not available for those in the high income group.

Footnote: - = no data value available.

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Figure 5.8. Adults age 18 and over who needed a translator during last doctor visit, California, by race/ethnicity, income, and education, 2008

Race / Ethnicity / Income / EducationPercent
All Hispanics9.5
Mexican9.9
Central American12.1
Non-Hispanic White0.5
All Asians3.0
Chinese4.9
Vietnamese5.3
Poor12.1
Low Income6.9
Middle Income2.4
High Income0.7
<High School14.1
High School Grad2.9
Any College1.3

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2008.

Note: For this measure, lower rates are better.

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Figure 5.9. Adults with a usual source of care whose health providers sometimes or never asked for the patient's help to make treatment decisions, by race, ethnicity, income, education, and English proficiency, 2008

Race / Ethnicity / Income / Education / English ProficiencyPercent
White15.0
Black17.5
Asian23.6
AI/AN14.0
>1 Race16.0
Non-Hispanic White14.3
Hispanic18.4
Poor19.2
Low Income16.2
Middle Income14.9
High Income14.9
<High School18.7
High School Grad16.2
Any College14.5
English Spoken at Home15.2
Other Language Spoken at Home18.8

Note: For this measure, lower rates are better.

Key: AI/AN = American Indian or Alaska Native.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2008.

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Current as of April 2012
Internet Citation: Chapter 5. Patient Centeredness (Text Descriptions): National Healthcare Disparities Report, 2011. April 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/chap5txt.html