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Language spoken at home and the association between ethnicity and doctor-patient communication in primary care: analysis of survey data for South Asian and White British patients.



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Brodie, Kara 
Abel, Gary 


OBJECTIVES: To investigate if language spoken at home mediates the relationship between ethnicity and doctor-patient communication for South Asian and White British patients. METHODS: We conducted secondary analysis of patient experience survey data collected from 5870 patients across 25 English general practices. Mixed effect linear regression estimated the difference in composite general practitioner-patient communication scores between White British and South Asian patients, controlling for practice, patient demographics and patient language. RESULTS: There was strong evidence of an association between doctor-patient communication scores and ethnicity. South Asian patients reported scores averaging 3.0 percentage points lower (scale of 0-100) than White British patients (95% CI -4.9 to -1.1, p=0.002). This difference reduced to 1.4 points (95% CI -3.1 to 0.4) after accounting for speaking a non-English language at home; respondents who spoke a non-English language at home reported lower scores than English-speakers (adjusted difference 3.3 points, 95% CI -6.4 to -0.2). CONCLUSIONS: South Asian patients rate communication lower than White British patients within the same practices and with similar demographics. Our analysis further shows that this disparity is largely mediated by language.



MEDICAL EDUCATION & TRAINING, PRIMARY CARE, Adult, Asian People, Communication, Communication Barriers, Cross-Sectional Studies, Ethnicity, Female, Health Care Surveys, Humans, Language, Male, Physician-Patient Relations, Primary Health Care, Quality of Health Care, Surveys and Questionnaires, United Kingdom, White People

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BMJ Open

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The work was conducted as part of an MPhil course, and involved secondary analysis of survey data designed and collected by a collaboration between the Cambridge Centre for Health Services Research at the University of Cambridge and the University of Exeter Medical School. KB was not employed by the University of Cambridge, nor did she receive any funding at any time during the project. GA and JB were funded for the original NIHR grant which funded the original survey but received no funding for this specific work. All authors read and approved the final manuscript. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The survey on which this secondary analysis was based was funded by a National Institute for Health Research Programme Grant for Applied Research (NIHR PGfAR) programme (RP-PG-0608-10050). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.