Cultural competency, patient-physician communication and gender disparities in patient satisfaction

Objectives: To determine whether gender differences in patient-physician communication, health care access and utilization, health literacy and physician's cultural competency contribute to the disparities in patients' satisfaction with health care among Hispanics.

Methods: A nationally representative sample of 1153 Latino adults age 18 or older in the United States from Commonwealth Fund Survey on Disparities in Quality of Health care was analyzed. Data were weighted post hoc in order to account for disproportionate sampling and demographic distortions due to non-response. Logistic regression analyses were conducted. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were computed to assess the significance of the factors explaining the gender differences.

Results: Overall, females expressed higher levels of satisfaction with health care than did males (63.5% vs. 36.4%, p<.001). Gender comparisons in patients' satisfaction with health care were explained by differences in physician's cultural competency and patient-physician communication. Females who reported being judged unfairly by medical staff (OR=2.70, CI=1.24, 5.87), or perceived that doctors looked down upon them (OR=3.04, CI=1.15, 8.03) were more likely to report less satisfied with health care services. However, males were more likely to report lower levels of satisfaction with health care services if they reported poor physician-patient communication in terms of explaining (OR=2.67, CI=1.06, 6.72) and participatory decision making (OR=3.26, CI=1.15, 9.30).

Conclusion: Understanding gender differences may help illuminate factors underlying disparities in patient satisfaction. It is vitally important to develop culture and gender tailored programs to fill in the gap in the quality of health care among Hispanics.