Tag: communication

Posted on

Women’s Experiences with Provider Communication and Interactions in Health Care Settings: Findings from the 2022 KFF Women’s Health Survey

Women’s Experiences with Provider Communication and Interactions in Health Care Settings: Findings from the 2022 KFF Women’s Health Survey

Introduction

Women’s health outcomes are shaped not only by access to care, health insurance, and affordability, but also by the social and economic factors that drive health, discrimination, and experiences within the health care system, which have become a larger focus in providing equitable health care in recent years. One of the Institute of Medicine’s six domains of healthcare quality is patient-centered care: providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. Measures of patient experience and Consumer Assessment of Healthcare Providers and Systems (CAHPS) Surveys have also become more widely used among health care organizations and clinics interested in assessing the patient-centeredness of the care they deliver and areas of improvement. in the health care system, which have become a larger focus in providing equitable health care in recent years.

This brief presents findings from the 2022 KFF Women’s Health Survey (WHS) on women’s experiences with the health care system including screening for social determinants of health, provider communication and interactions, and discrimination. The KFF WHS is a nationally representative survey of 5,145 self-identified women ages 18 to 64, conducted May 10 – June 7, 2022. See the Methodology section for more details.

Summary of Findings

  • Among women ages 18-64 who have seen a health care provider in the past two years:
    • Twenty-nine percent report that their doctor had dismissed their concerns in that time period, 15{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} reported that a provider did not believe they were telling the truth, 19{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} say their doctor assumed something about them without asking, and 13{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} say that a provider suggested they were personally to blame for a health problem. A higher share of women (38{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) than men (32{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) report having had at least one of these negative experiences with a health care provider.
    • One in ten (9{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) women ages 18-64 say that they have experienced discrimination because of their age, gender, race, sexual orientation, religion, or some other personal characteristic during a health care visit in the past two years.
    • Few women report being asked about social and economic factors that may influence health. While 58{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} report that in the past two years their provider asked them about what kind of work they do, far fewer report having been asked about their housing situation (30{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), their ability to afford food (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), or access to reliable transportation (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}). Women with Medicaid and those with low incomes are more likely to say they have been asked about these last three indicators than women with private insurance and those with higher incomes.
  • Communication is an important component of health care quality; however, 21{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of women (including 38{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of uninsured women), say it is difficult to find a doctor who explains things in a way that is easy to understand.
  • Just over one-third (35{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) of women ages 40-64 say their health care provider ever talked to them about what to expect in menopause.

Screening for Social Determinants of Health

In recent years, the social determinants of health have been recognized as critical factors that shape health outcomes. These factors include housing, transportation, nutrition, and financial well-being. Although there are no formal recommendations for routine screening for social determinants of health, a recent review conducted for the U.S. Preventive Services Task Force found that screening for risk factors including housing, food security, and transportation shows positive effects on health outcomes. In fact, six health professional organizations specifically encourage social risk screening and referrals in clinical settings (American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Diabetes Association, and American Osteopathic Association).

HRSA-funded federally qualified health centers (FQHCs), which provide primary care services in underserved areas, must report whether they screen patients for social risk factors and if so, the total number of patients that screened positive for food insecurity, housing insecurity, financial strain, and lack of transportation/access to public transportation. One study found that the majority of FQHCs collected this type of information, but some evidence suggests these screenings may be less common in other health care settings. Medicaid contracts are also increasingly requiring managed care plans to screen for the social determinants of health and many plans report being engaged in activities to address enrollees’ social needs.

Nearly three in five (58{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) women who have visited a doctor in the past two years say they were asked about the kind of work they do, but only one in five were asked about their ability to afford food (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) or access to reliable transportation (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}).

Fifty-eight percent of women who have seen a health care provider in the past two years report that their provider asked about what kind of work they do in the past two years (Table 1).

Three in ten (30{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) women who have seen a health care provider in the past two years report having been asked about their housing situation, with higher shares among uninsured women (32{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), women with Medicaid coverage (44{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), and women with low incomes (37{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}).

Fewer women report that their provider asked them about their ability to afford food (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) or access to reliable transportation (20{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}). A larger share of uninsured women (27{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} and 23{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, respectively) and women with Medicaid (34{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} and 33{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, respectively) say they were asked about these two topics than women with private insurance (15{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} and 14{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, respectively).

Black and Hispanic women are more likely than White women to say they were asked about their housing situation, ability to afford food, and access to reliable transportation. Women ages 18-35 are more likely than women ages 50-64 to say they have been asked about all of these topics by their provider in the past two years.

A higher share of women in 2022 say that in the past two years their health care provider asked them about their housing, ability to afford food, and access to transportation than did in 2020 (19{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, 13{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, and 13{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}, respectively).

Provider Communication

Communication is an important component of health care quality but one in five (21{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) women say it is difficult to find a doctor who explains things in a way that is easy to understand.

Approximately one in four younger women (23{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), women with a high school degree or less (23{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), Hispanic women (24{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), and women with low incomes (26{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) have found it difficult to find a doctor who explains things in a way that is easy to understand (Figure 1). This share was highest among uninsured women, where more than one-third (36{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) say it is difficult. These findings could reflect language barriers experienced by people with limited English proficiency, and difficulties faced by people with lower health literacy.

Menopause is a topic that has received little attention and there is a lack of information about what to expect during menopause.

One aspect of women’s health that is often not discussed with clinicians is menopause and what women can expect during this transition. Just over one-third (35{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) of women ages 40-64 say their health care provider ever talked to them about what to expect in menopause (Figure 2), with wide variation by current menstrual status. Forty-two percent of women who have gone through menopause, 39{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of those currently going through menopause, and 19{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of premenopausal women say a provider has ever talked to them about what to expect in menopause. Providing information about what to expect during menopause can ease women’s concerns about the changes they may experience after their reproductive years and offer women options for clinical interventions.

Provider Interactions

Women are more likely than men to report experiencing certain negative provider interactions.

Negative interactions within the health care system can contribute to poorer health outcomes, distrust of the health care system, and health inequities. Among women and men ages 18-64 who have visited a health care provider in the past two years, 29{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of women ages 18-64 report that their doctor had dismissed their concerns during that time, compared to 21{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of men (Figure 3). Fifteen percent of women said they have had a provider not believe they were telling the truth, compared to 12{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of men. Nine percent of women who have visited a health care provider in the past two years said they had experienced discrimination because of their age, gender, race, sexual orientation, religion, or some other personal characteristic, compared to 5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of men.

A similar share of women (19{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) and men (16{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) who have been to a doctor in the past two years say their doctor assumed something about them without asking in the past two years. The same share of women and men say that a provider suggested they were personally to blame for a health problem (13{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}). Overall, a higher share of women than men say they have had at least one of these experiences in the past two years (38{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} vs. 32{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}).

Among women who have visited a health care provider in the past two years, larger shares of those who are covered by Medicaid or uninsured, or who have low incomes, or a disability or ongoing health condition report having had each of these four negative experiences with their provider during that time period.

Thirty-six percent of women with a disability or ongoing health condition report that a health care provider had dismissed their concerns in the past two years compared to 22{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of women who do not (Table 2). A higher share of Black women (18{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) who have seen a provider in the past two years say that their provider did not believe they were telling the truth than White women (15{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), and a higher share of White women than Asian/Pacific Islander (7{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) women say the same. More than four in ten women ages 18-35 (46{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), uninsured (46{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), with Medicaid coverage (44{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}), or with a disability or ongoing health condition (45{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) who have been to a doctor in the past two years report having had at least one of these interactions.

The impacts of bias, racism, and discrimination in health care has garnered increased attention in recent years and is recognized as having detrimental effects on women’s health. Some women report experiencing discrimination at higher rates than others. Twice as many women (10{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) ages 18-49 say they have experienced discrimination during a health care visit as women ages 50-64 (5{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}) (Table 2). A larger share of Black women ages 18-64 who have visited a health care provider in the past two years reports experiencing discrimination than White women (13{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} vs. 7{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc}). Women with low incomes and those with Medicaid or who are uninsured also report experiencing discrimination because of their age, gender, race, sexual orientation, religion, or some other personal characteristic at higher rates than their counterparts.

Our discrimination survey question aims to understand people’s perceptions of various actions and experiences as discrimination. Whereas some other surveys have asked respondents about experiencing “unfair treatment” in a variety of different settings or in general, our survey takes a different approach by asking one specific question about perceived discrimination in the context of a health care visit in the past two years. People may experience different types of unfair treatment but not necessarily describe it as discrimination. As a result, surveys that ask about unfair treatment more broadly tend to have higher shares of respondents who say they have experienced that.

Conclusion

The role of social determinants on health outcomes has garnered increased recognition in recent years. Providers are increasingly discussing factors with their patients that shape access to health care and health outcomes such as food insecurity and transportation challenges, although ensuring providers have resources with which to connect patients to address these social determinants is still a challenge. Gender bias and racial discrimination in the health care system can contribute to health disparities and poorer health outcomes. Women are more likely than men to report having experienced some type of health care bias, particularly those who are in poorer health, younger, or have low incomes.

Efforts to improve provider communication and interactions and address discrimination could improve women’s experiences with the health care system, alleviate some of the barriers many women still experience when they seek care, and reduce health disparities.

Posted on

Top administrative challenges for 2023: Patient communication

Top administrative challenges for 2023: Patient communication

The No. 3 administrative challenge dealing with clinical methods in 2023.

Editor’s Take note: Every calendar year, Professional medical Economics® asks our medical doctor viewers what troubles they are experiencing in their procedures. And just about every yr, we get the identical remedy as the leading obstacle: administrative burdens. For our to start with situation of 2023, we determined to acquire a stab at fleshing out what some of people administrative burdens are and what medical professionals can do about them in their practice. We concentrated on five administrative burdens that our viewers typically notify us are key concerns.

It was not so extensive back, reasonably talking, that medical doctors and healthcare techniques experienced only a couple techniques of communicating with people (and vice versa): in individual, by landline phone, or through U.S. mail.

Now those days appear to be as quaint as the era of vacation by horse and buggy. These days health care vendors and people have a myriad of new communication equipment at their disposal, this sort of as text messaging, telehealth, client portals and social media platforms — not to point out the common use of cell telephones.

The explosion in interaction systems provides several problems for medical professionals and medical practices, starting off with patient expectations. Patients, particularly younger kinds, assume the very same simplicity and ease in speaking with their medical doctor that they uncover when procuring or purchasing a food on the net. In a recent study of 2,000 grown ups, 61{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} mentioned they wished health and fitness care to mimic the encounter furnished by a consumer service application, and 79{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} explained they needed the means to use engineering to regulate their overall overall health treatment expertise.

“Patients want the benefit of connecting with your apply nonetheless and when they want — by mobile phone, site or textual content, inside of or outside the house business office hours,” claims Justin Jacobson, vice president of affected person engagement solutions for Nuance Communications Inc., a technological innovation firm that offers conversational artificial intelligence answers.

COVID-19’s arrival more highlighted the value that sufferers location on speaking with their health practitioner. In a 2021 study of people by well being treatment computer software enterprise SymphonyRM, now Actium Health and fitness, 41{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of respondents reported they experienced considerably less self-confidence in their doctor given that the arrival of COVID-19, generally because of to a deficiency of communication about the sickness. Conversely, people who documented a lot more self confidence reported it was owing to their provider’s immediate transition to digital treatment, frequency of conversation about COVID-19 and use of electronic conversation applications.

For medical methods, the implications are clear. Their achievements significantly is dependent on their potential to purchase and combine the conversation channels that clients have come to hope in other features of their every day lives. Techniques that fulfill those expectations can enjoy added benefits this sort of as greater concentrations of client engagement and loyalty, a more powerful bottom line and enhanced affected person outcomes.

Amid the more recent conversation resources, texting may well offer you the most advantages for the the very least cost and work. Tactics can use automated textual content messages to remind sufferers of forthcoming appointments (thus lessening no-demonstrates), share pre-appointment needs these types of as fasting, and tell them when they are due to get preventive services like colonoscopies and vaccinations.

In addition, adhere to-up textual content messages are much more productive than telephone phone calls at minimizing medical center readmissions or emergency office visits next healthcare facility discharge, according to a 2022 research published in JAMA Network Open up.

A more advantage of texting is its level of popularity with clients. A 2021 wellbeing study by Healthcare Details and Administration Programs Culture/Solutionreach Inc. observed that 65{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of patients want to get appointment confirmation/reminders and pre-take a look at treatment guidance by using textual content concept. What’s more, additional than a person-third of those surveyed — such as 64{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of those age 50 and younger — reported they’d be keen to improve companies to obtain textual content messages and other modern day varieties of interaction. Practically 90{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} cited usefulness as the main motive why they chosen texting versus other implies of communicating with their medical doctor.

Finally, the aim of all patient communications ought to be to make an approach that “empowers people to develop into active participants in their treatment,” claims Gary Hamilton, CEO of InteliChart, a developer and provider of affected person engagement answers. “This calls for physicians and all other professional medical staff to acquire great conversation competencies and handle affected person needs proficiently.”

Here are 4 suggestions for working with new systems to increase affected person communications:

  • Attempt to meet patients where by they are. Uncover out what manner of communication every single affected individual prefers and use it as substantially as feasible when communicating with that individual.
  • Install and use as numerous various interaction types as your observe finances allows, and enable patients know you have them and how to use them.
  • Assign a staff members member responsibility for checking the affected person portal, such as answering patients’ thoughts about how to use it and what facts is accessible on it and triaging messages and requests that occur via it.
  • Look at with a wellness care attorney or your local clinical modern society to ensure that all your client communication tools are compliant with the Health Insurance plan Portability and Accountability Act of 1996.