Impact of patient and socio-demographic factors on perception of patient-centered care among people with chronic health conditions

BACKGROUND: Patient centered care (PCC) refers to the provision of care that is respectful and sensitive to patient preferences, needs, and values. Studies show PCC is associated with improved communication, greater participation in health decision-making, and better healthcare outcomes. On average, chronic disease patients have more healthcare visits than other patients and the prevalence of chronic diseases has increased over the past decade. However, PCC is understudied in chronic disease patients. OBJECTIVE: To assess the impact of patient factors (patient's attitude toward health and healthcare, patient knowledge about their chronic conditions, patient's participation in medical treatment) and patient demographic factors on chronic disease patients' perception of PCC, based on the Mead and Bower conceptual framework. METHODS: Data from the 2007 Health Tracking Household Survey was analyzed. Study population: The analytic was 6,713 respondents with chronic condition(s). Analysis: Bivariate analysis was performed to assess relationship between patient attitudes, knowledge, and participation and patient perception of PCC using chi squared. Multivariate analysis was conducted to examine the impact of patient factors and patient demographic factors on PCC. RESULTS: Overall, the respondents were 45 years of age or older (85%), female (57%), non-Hispanic white (73%), insured by public (42%) or private (48%) insurance and live in a MSA (82%). Patients who have better knowledge on the effects of prescribed medications (OR=1.47), understanding on the nature and causes of their condition (OR=1.30), and medical treatment options (OR=1.40) were more likely to evaluate that the explanations from their health care providers are easy to understand. Patients more likely to perceive as being treated with respect and dignity were those with: higher confidence in telling health concern and finding solution (OR=2.90), better knowledge of the disease (OR=1.39) and medication effects (OR=1.50). Females, Hispanics, and patients with lower health status, were less likely to perceive as being treated with respect and dignity. Patients more likely to perceive providers as spending enough time with them were those with: higher confidence in telling health concern (OR=3.07), and better knowledge of the disease and medication effects (OR=1.34). Patients active in their own healthcare, and those with lower health status were less likely to perceive providers as spending enough time with them. CONCLUSION: Chronic disease patient who are knowledgeable concerning medication, their health condition, and treatment options have higher perceptions of PCC. Increasing chronic disease patient healthcare knowledge could potentially improve how they interface with the healthcare system.