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Greater risk of hospitalizations tied to poor physician-patient experience in Hispanic patients with CKD
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A lower perceived quality of patient-physician interaction was associated with a greater risk of hospitalization in Hispanic patients with chronic kidney disease, but the quality of the interaction did not place these patients at greater risk of developing kidney failure or death, according to a study.
“The influence of the patient experience with their primary care physician on hospitalization is of particular relevance to the Hispanic population with CKD,” wrote Esteban A. Cedillo-Couvert, MD, and colleagues as part of the Hispanic Chronic Renal Insufficiency Cohort Study. “Hispanics are the largest minority in the United States. It is estimated that 57.5 million Hispanics currently reside in the United States and this number is projected to double in the next 20 years. Consequently, there will be continued growth of the Hispanic CKD population, which is currently estimated at 8.6 million. Furthermore, this population may face challenges to the quality of the patient-provider interactions related to language (ie, low English proficiency) and cultural factors (eg, values and beliefs).”
The ongoing ancillary study to a multicenter study looked at 252 English- and Spanish-speaking Hispanic patients with CKD and an eGFR of 20 to 70 ml/min per 1.73m2 from October 2005 to June 2008. Patient experiences with their primary care physicians were assessed by a survey that scored communication quality, whole-person orientation, health promotion, interpersonal treatment and trust.
During a median follow-up of 4.8 years, investigators found 619 hospitalizations; 103 kidney failure events; and 56 deaths. As compared with higher scores in the survey, lower scores were associated with a greater risk for hospitalization (a 54% higher risk with poor communication, a 31% higher risk with poor health promotion, a 50% higher risk with poor interpersonal treatment and a 57% higher risk with lack of trust). There were no significant links between scores with the development of kidney failure or with death.
“We were interested in evaluating the association of the patient experience with their primary care physician with hospitalization and other outcomes,” said co-investigator James P. Lash, MD, of the department of medicine at the University of Illinois at Chicago, in a press release about the study. “We were able to accomplish our goal and found that lower perceived quality of the patient experience with their primary care physician was associated with a higher risk of hospitalization.”
In an accompanying editorial, Delphine S. Tuot, MDCM, MAS, from the University of California, San Francisco, noted that data such as those published in this study “provide evidence that better patient care experiences are also associated with less health care utilization and provide a step toward the overarching goal of achieving the quadruple aim: high-quality and cost-effective care delivery that improves population health and achieves high satisfaction among providers, care-team members and patients,” according to the press release.
Reference:
www.asn-online.org/about/press/releases/
Disclosures: The authors reported no relevant financial disclosures.
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