The 130th Annual Meeting of APHA

4211.0: Tuesday, November 12, 2002 - 3:20 PM

Abstract #47692

Communication barriers in the Asian American patient population: Findings from The Commonwealth Fund 2001 Health Care Quality Survey

Dora L. Hughes, MD, MPH1, Quyen Ngo-Metzger, MD, MPH2, Karen Scott Collins, MD, MPH1, and Allyson Gail Hall, PhD3. (1) The Commonwealth Fund, 1 East 75 Street, New York, NY 10021, (2) Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, LY-330, Boston, MA 02215, 617 667 4221, DLH@cmwf.org, (3) United Hospital Fund, Empire State Building, 350 Fifth Avenue, 23rd Floor, New York, NY 10118

The Commonwealth Fund 2001 Healthcare Quality Survey, a national survey of 6722 adults with over-samples of 669 Asian American, 1037 African American and 1153 Hispanic adults, was conducted by Princeton Survey Research Associates, May –November 2001. This telephone, random digit-dial survey explored a number of domains of health care quality with a special focus on communication and cultural barriers. Survey analysis included six Asian American (AA) populations: Chinese, Korean, Vietnamese, Filipinos, Indian, and Japanese

Findings:

• Chinese, Vietnamese, Koreans and Indians were more likely to report that their doctor did not listen to everything, they were unable to understand everything and they did not ask questions when needed. For example, 29 percent of Chinese, 41 percent of Vietnamese said they were able to understand everything, compared to 68 percent of Filipinos • For all groups, higher rates of communication difficulties were associated with less involvement in decision-making, less time with the doctor than wanted and higher rates of noncompliance. • With the exception of Filipinos, Asians, especially Koreans, are overall less likely to report that their doctor understands their background and values and twice as likely to believe that their doctor looks down on them. Again, substantial variation is seen across groups-- more than 1 in 4 Indians and Vietnamese hold this belief compared with less than 1 in 10 Japanese.

Conclusions: The AA population is the fastest growing minority population in the U.S. and exhibits the lowest levels of health care utilization. Low levels of utilization may be associated with negative experiences with the health care system. It is important to recognize that as a group Asian Americans are not monolithic - there is substantial variation in their experiences with the health care system. Programmatic interventions aimed at improving access and utilization must be attuned to the differences in communication and culture across all racial and ethnic subgroups. This is critically important to understanding and improving the health of these populations.

Learning Objectives: At the end of the presentation, participants should be able to

Keywords: Asian and Pacific Islander, Minority Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Quality Improvement Contributed Papers #2: Racial and Ethnic Disparities

The 130th Annual Meeting of APHA