Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey.

Abstract

BACKGROUND: Doctor-patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor-patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. AIM: To determine how reported GP-patient communication varies between patients from different ethnic groups, stratified by age and gender. DESIGN AND SETTING: Analysis of data from the English GP Patient Survey from 2012-2013 and 2013-2014, including 1,599,801 responders. METHOD: A composite score was created for doctor-patient communication from five survey items concerned with interpersonal aspects of care. Mixed-effect linear regression models were used to estimate age- and gender-specific differences between white British patients and patients of the same age and gender from each other ethnic group. RESULTS: There was strong evidence (P<0.001 for age by gender by ethnicity three-way interaction term) that the effect of ethnicity on reported GP-patient communication varied by both age and gender. The difference in scores between white British and other responders on doctor-patient communication items was largest for older, female Pakistani and Bangladeshi responders, and for younger responders who described their ethnicity as 'Any other white'. CONCLUSION: The identification of groups with particularly marked differences in experience of GP-patient communication--older, female, Asian patients and younger 'Any other white' patients--underlines the need for a renewed focus on quality of care for these groups.