Examination from the Patient Perspective of Factors and Influences of Cost of Care-Related Communication between Physicians and African American Women with Asthma.
Year: 2013
Type: article
Study design: Observational Study
Abstract: Asthma is a prevalent chronic condition where associated costs to patients are high and perceptions of financial burden may be evident. Communication between clinician and patient (cost of care-related communication) may mitigate perceptions and improve disease management. Through mixed methods approaches, this dissertation examined 1) economic factors that mediate patient characteristics and perception of financial burden and preferences for cost of care-related communication, 2) associations between cost of care-related communication and asthma self-management behaviors, and 3) clinical factors that mediate communication and asthma-related urgent care use. Baseline data were collected from 343 African American women seeking services for asthma in Southeast Michigan. Additional qualitative data were collected from sub-samples via two focus groups (n=14) and in-depth interviews (n=25). Mediation was assessed with structural equation modeling. In the first and second study, associations between perceptions of financial burden, preferences for cost of care-related communication, and patient characteristics were examined through hypothesized mediators (household income, health insurance, out-of-pocket expenses). In the third study, the relationship between cost of care-related communication and self-management behaviors and urgent care use was assessed with linear regression models, and structural equation models. Coded transcripts from the qualitative data were analyzed for themes to provide supporting information. More than half of women with asthma reported perceptions of financial burden. Three-fourths reported a preference to discuss cost with their clinician; however, less than half reported such discussions actually occurring. Household income, health insurance, and out-of-pocket expenses accounted for the relationships between patients’ characteristics and their perceptions of burden and preferences for communication. No associations between cost of care-related communication, self-management behaviors and asthma-related urgent care use were found. Many people perceive financial burden and would like to discuss cost with their clinician, but these discussions occur infrequently, and are often initiated by patients. Burden may be present despite having economic resources. Given the high percentage of women desiring cost-of-care discussions, more research is needed in order to strengthen capacity of care teams and patients in order to integrate financial concerns with disease management into routine care.
Author: Minal Patel
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W430166710