Speaking Up and Walking Out: Are Vulnerable Patients Less Likely to Disagree With or Change Doctors?

BACKGROUND:Disparities in clinical process-of-care and patient experiences are well documented for Medicare beneficiaries with ≥1 social risk factors. If such patients are less willing to express disagreement with their doctors or change doctors when dissatisfied, these behaviors may play a role in...

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Bibliographic Details
Published in:Medical care 2018-09, Vol.56 (9), p.749-754
Main Authors: Martino, Steven C, Elliott, Marc N, Mallett, Joshua S, Orr, Nate, Gaillot, Sarah, Haviland, Amelia M
Format: Article
Language:English
Subjects:
Beneficiaries
Government programs
Health care
Health disparities
Health risks
Medical personnel
Medicare
Minority & ethnic groups
Patients
Physicians
Predictive control
Regression analysis
Regression models
Risk analysis
Risk factors
Risk management
Subgroups
Teaching methods
Citations: Items that this one cites
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Summary:BACKGROUND:Disparities in clinical process-of-care and patient experiences are well documented for Medicare beneficiaries with ≥1 social risk factors. If such patients are less willing to express disagreement with their doctors or change doctors when dissatisfied, these behaviors may play a role in observed disparities. OBJECTIVE:To investigate the association between social risk factors and self-reported likelihood of disagreeing with or changing doctors if dissatisfied among the Medicare fee-for-service population. SUBJECTS:Fee-for-service beneficiaries (N=96,317) who responded to the 2014 Medicare Consumer Assessment of Healthcare Providers and Systems survey. Subgroups were defined based on age, education, income, and race/ethnicity. METHODS:Respondents reported how likely they would be to express disagreement with their doctors and change doctors if dissatisfied (1=very unlikely to 4=very likely; rescaled to 0–100 points). We fit mixed-effect linear regression models predicting these outcomes from social risk factors, controlling for health status and geographic location. RESULTS:Beneficiaries who were older, less educated, and had lower incomes were least inclined to express disagreement or change doctors (P
ISSN:0025-7079
1537-1948
DOI:10.1097/MLR.0000000000000936