Patient Experience with Primary Care Physician and Risk for Hospitalization in Hispanics with CKD
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: In the general population, the quality of the patient experience with their primary care physician may influence health outcomes but this has not been evaluated in CKD. This is relevant for the growing Hispanic CKD population, which potentially faces challenges to the quality of the patient experience related to language or cultural factors. We evaluated the association between the patient experience with their primary care physician and outcomes in Hispanics with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: , enrolled in the Hispanic Chronic Renal Insufficiency Cohort study between 2005 and 2008. Patient experience with their primary care physician was assessed by the Ambulatory Care Experiences Survey subscales: communication quality, whole-person orientation, health promotion, interpersonal treatment, and trust. Poisson and proportional hazards models were used to assess the association between the patient experience and outcomes, which included hospitalization, ESKD, and all-cause death. RESULTS: . Over 4.8 years (median) follow-up, there were 619 hospitalizations, 103 ESKD events, and 56 deaths. As compared with higher subscale scores, lower scores on four of the five subscales were associated with a higher adjusted rate ratio (RR) for all-cause hospitalization (communication quality: RR, 1.54; 95% confidence interval [95% CI], 1.25 to 1.90; health promotion: RR, 1.31; 95% CI, 1.05 to 1.62; interpersonal treatment: RR, 1.50; 95% CI, 1.22 to 1.85; and trust: RR, 1.57; 95% CI, 1.27 to 1.93). There was no significant association of subscales with incident ESKD or all-cause death. CONCLUSIONS: Lower perceived quality of the patient experience with their primary care physician was associated with a higher risk of hospitalization.
DOI: 10.2215/cjn.03170318
Authors: Esteban A. Cedillo-Couvert, Jesse Y. Hsu, Ana C. Ricardo, Michael J. Fischer, Ben S. Gerber, Edward J. Horwitz, John W. Kusek, Eva Lustigova, Amada Renteria, Sylvia E. Rosas, Milda Saunders, Daohang Sha, Anne Slaven, James P. Lash, on behalf of the CRIC Study Investigators
Institutions: University of Illinois Chicago, University of Pennsylvania, Jesse Brown VA Medical Center, MetroHealth, MetroHealth Medical Center, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Tulane University, Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Harvard University, University of Chicago
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Awards: G1060671437, G1201304535, Clinical and Translational Science Institute, G1710642513, G1815451664, Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study, Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, General Clinical Research Center, Gender Disparities and Vascular Function in Chronic Kidney Disease Outcomes, G5931204509, Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, G797306165, G815100389, Health Disparities in Chronic Kidney Disease Mentoring Program, Clinical and Translational Science Collaborative of Cleveland, Clinical and Translational Science Collaborative of Cleveland, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases, A pilot trial of an intervention to support initial type 2 diabetes selfmanagement among younger adults with children., Prospective renal insufficiency cohort evaluation: PRICE, Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study, G992700738
OpenAlex ID: W2897329451