Experiences of patient-provider concordance in healthcare among All of Us participants, 2017-2023.

Abstract

To examine differences in care experiences and preferences related to patient-provider relationships across both cultural and personal patient identities. Logistic regression was used to test the associations between patient characteristics and patient survey responses using 2017-2023 data from the All of Us dataset. Nearly two thirds of the All of Us participants considered it important that their providers were like them (63.2 %) and could often see them (66.3 %). The odds of reporting that it was important that their providers were like them were higher among all groups compared to non-Hispanic White participants (non-Hispanic Black: aOR 2.59 95% Confidence Interval (CI) [2.41-2.78]; Hispanic: aOR 1.42 95% CI [1.33-1.51]; non-Hispanic Asian: aOR 1.45 95% CI [1.33-1.59]; non-Hispanic Other: aOR 1.16 95% CI [1.08-1.25]). Female participants (aOR 1.29 95% CI [1.25-1.33]), those that spoke a language other than English at home (aOR 1.45 95% CI [1.38-1.53]), those with Medicaid (aOR 1.23 95% CI [1.15-1.32]) or no insurance (aOR 1.17 95% CI [1.10-1.25]) compared to those privately insured, and those with a disability (aOR 1.15 95% CI [1.11-1.20]) were more likely to report that it was very/somewhat important their provider be similar to them. The results of this study suggest that the dimensions of patient identity contribute to inequities in receiving culturally concordant care. The significant subgroup differences across all survey questions suggest that previous interventions addressing cultural competence in providers may not reach all the patient populations. Instead of a one-size-fits-all approach to improving the care experiences of different patient populations, adopting the key behaviors derived from both patient-centered and culturally competent care and by using the guiding principles of cultural humility would enable providers to tailor care that is centered on patient needs and preferences.