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      Doctor-patient communication: a review and a rationale for using an assessment framework

      research-article
      Ariel Belasen , Alan T. Belasen
      Journal of Health Organization and Management
      Emerald Publishing
      Assessment, Doctor–patient communication

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose

          The purpose of this paper is to explore the extent to which improving doctor–patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

          Design/methodology/approach

          The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC.

          Findings

          The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor–patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients’ overall ratings of hospitals.

          Research limitations/implications

          More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse.

          Practical implications

          When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program’s efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.

          Originality/value

          The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.

          Related collections

          Most cited references78

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          Adherence to Medication

          New England Journal of Medicine, 353(5), 487-497
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            The patient experience and health outcomes.

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              The impact of patient-centered care on outcomes.

              We designed this observational cohort study to assess the association between patient-centered communication in primary care visits and subsequent health and medical care utilization. We selected 39 family physicians at random, and 315 of their patients participated. Office visits were audiotaped and scored for patient-centered communication. In addition, patients were asked for their perceptions of the patient-centeredness of the visit. The outcomes were: (1) patients' health, assessed by a visual analogue scale on symptom discomfort and concern; (2) self-report of health, using the Medical Outcomes Study Short Form-36; and (3) medical care utilization variables of diagnostic tests, referrals, and visits to the family physician, assessed by chart review. The 2 measures of patient-centeredness were correlated with the outcomes of visits, adjusting for the clustering of patients by physician and controlling for confounding variables. Patient-centered communication was correlated with the patients' perceptions of finding common ground. In addition, positive perceptions (both the total score and the subscore on finding common ground) were associated with better recovery from their discomfort and concern, better emotional health 2 months later, and fewer diagnostic tests and referrals. Patient-centered communication influences patients' health through perceptions that their visit was patient centered, and especially through perceptions that common ground was achieved with the physician. Patient-centered practice improved health status and increased the efficiency of care by reducing diagnostic tests and referrals.
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                Author and article information

                Contributors
                Journal
                JHOM
                10.1108/JHOM
                Journal of Health Organization and Management
                JHOM
                Emerald Publishing
                1477-7266
                26 October 2018
                22 November 2018
                : 32
                : 7
                : 891-907
                Affiliations
                [1]Department of Economics and Finance, Southern Illinois University Edwardsville , Edwardsville, Illinois, USA
                [2]MBA Program, SUNY Empire State College, Saratoga Springs, New York, USA
                Author notes
                Ariel Belasen can be contacted at: abelase@siue.edu
                Article
                618115 JHOM-10-2017-0262.pdf JHOM-10-2017-0262
                10.1108/JHOM-10-2017-0262
                30465487
                2f5ab61a-6409-4277-9189-3453890d8d78
                © Emerald Publishing Limited
                History
                : 17 September 2017
                : 02 October 2017
                : 18 July 2018
                : 24 September 2018
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 74, Pages: 17, Words: 8416
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                cat-HMAN, Healthcare management
                Custom metadata
                yes
                yes
                JOURNAL
                included

                Health & Social care
                Doctor–patient communication,Assessment
                Health & Social care
                Doctor–patient communication, Assessment

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