Socio-economic status and patient-physician communication among the older Japanese: Japan gerontological evaluation study

Background: Poor patient-physician communication is recognized as contributing factor to health disparities through mechanisms such as poor understanding or adherence. Studies in western nations indicate that being old or in low socio-economic status are associated with poor patient-physician communication. This study aims at exploring such association among the old (65+) in Japan. Data: We used the A version of the Japan Gerontological Evaluation Study (JAGES) data (N=22,743). This is the self-administered survey conducted in 2010 in 25 municipalities. Patient-physician communication was assessed with two questions; ″How would you rate how well your doctor listened to you?″and ″How would you rate how well the doctor explained things in a way you could understand?″ Since health literacy and physician trust are reportedly associated with patient-physician communication, we asked about these as well. Results: Being in lower socio-economic status was not associated with poor communication with doctors. Although those with higher socio-economic status had more interest in health information, they tended to report poor communication and lower trust in doctors. Older subjects and women were significantly more likely to report better communication and more trust in doctors. On the contrary, men were less likely to have trust in doctors and perceived that they did not explain things in a way they could understood. Discussion and conclusion:Among Japanese elderly, low socio-economic status was not associated with poor patient-physician communication. These findings suggest the importance of considering other aspects such as culture or medical system when investigating patient-physician communication.