Predictors of Satisfaction With Doctor and Nurse Communication: A National Study

Abstract

Prior research indicates that effective communication between medical providers and patients is associated with a number of positive patient outcomes, yet little research has examined how ecological factors (e.g., hospital size, local demographics) influence patients' reported satisfaction with doctor and nurse communication. Given the current emphasis on improving patient satisfaction in hospitals across the United States, understanding these factors is critical to interpreting patient satisfaction and improving patient-centered communication, particularly in diverse and dense populations. As such, this study examined county-level data including population density, population diversity, and hospital structural factors as predictors of patient satisfaction with doctor and nurse communication. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), U.S. Census data, and number of hospital beds were obtained from publicly available Hospital Compare, U.S. Census, and American Hospital Directory websites, respectively. Multivariate regression modeling was performed for the individual dimensions of HCAHPS scores assessing doctor and nurse communication. Standardized partial regression coefficients were used to assess strengths of county-level predictors. County-level factors accounted for 30% and 16% of variability in patient satisfaction with doctor and nurse communication, respectively. College education (β = 0.45) and White ethnicity (β = 0.25) most strongly predicted a favorable rating of doctor and nurse communication, respectively. Primary language (non-English speaking; β = -0.50) most strongly predicted an unfavorable rating of doctor communication, while number of hospital beds (β = -0.16) and foreign-born (β = -0.16) most strongly predicted an unfavorable rating of nurse communication. County-level predictors should be considered when interpreting patient satisfaction with doctor and nurse communication and designing multilevel patient-centered communication improvement strategies. Discordant findings with individual-level factors should be explored further.

Understanding the influences and impact of patient‐clinician communication in cancer care

“…This includes not only the communication channel, but also things like the patient‐provider relationship context as well as the broader organizational and policy context. It is our belief, that just as the importance of context is beginning to be understood in the field of implementation science, so too is the importance of context in the communication field likely to grow . This is due in part to the increased attention and weight patient‐communication is receiving within the realm of pay‐for‐performance plans.…”

“…High‐quality communication between patients and clinicians is thought to be central to patient‐centred care . Medical payment programmes, including those of the Centers for Medicare and Medicaid Services (CMS), now consider patients’ satisfaction with clinician communication given its importance to care outcomes . Despite such endorsements and incentives, how and when different communication exchanges impact specific patient outcomes is only beginning to be understood.…”

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