Patient-provider communication quality: Impact of patients' weight, race and ethnicity.

Abstract

This study examined variations in patient-provider communication quality by weight status, and weight-race/ethnicity status, among adult patients aged ≥ 18 years in the U.S. We conducted a cross-sectional secondary analysis of 2015-2020 data from the Medical Expenditure Panel Survey (MEPS) household component (N = 23,047). Descriptive statistics and bivariate analyses were used to characterize the study population. Multivariable logistic and linear regression were used to examine the relationship between patients' weight status and communication quality. Patients with a BMI ≥ 40.0 (obesity class III) had a statistically significantly lower composite communication quality score (86.7), compared to healthy weight patients (87.8). Compared to healthy weight patients, patients with obesity had a statistically significant 19% lower odds of reporting providers listened carefully or showed respect for what they said (adjusted odds ratio [aOR]: 0.81, 95%CI: 0.69-0.94 and aOR: 0.81, 95% CI: 0.69-0.95, respectively). NH-Whites with obesity had a lower odds of reporting providers listened carefully, showed respect, and spent enough time with them. Hispanics with obesity showed a lower odds of experiencing high-quality explanations (aOR: 0.71, 95% CI: 0.54-0.92). NH-Blacks with obesity had a statistically significant 24-49% lower odds of reporting providers listened and gave high-quality explanations in the unadjusted model (OR: 0.76, 95%CI: 0.58-0.98 and OR: 0.51, 95% CI: 0.40-0.65, respectively), but not in the adjusted models. Adult patients with obesity experience a lower quality of communication with their health care providers, particularly relating to listening and shows of respect, compared to adults with a healthy weight. Disparities in patient-provider communication quality persist among racial/ethnic minorities with overweight and obesity. Findings from this study may inform educational and research endeavors which aim to enhance patient-provider communication and the quality of care among adults with overweight and obesity.