Quality of Physician–Patient Communication During Hospitalization

1Vanderbilt University, Nashville, TN
2Vanderbilt University, Nashville, TN
3Vanderbilt University, Nashville, TN
4Emory University, Atlanta, GA
5Emory University, Atlanta, GA

Meeting: Hospital Medicine 2009, May 14-17, Chicago, Ill.

Abstract number: 60

Background:

Patients often do not understand or recall information presented during their hospitalization. Poor physician–patient communication in the hospital setting is related to adverse events and readmissions. In outpatient research, health literacy is strongly associated with patients' understanding of health information, but inpatient data are limited. We analyzed patients' ratings of their communication experience during hospitalization and how this varies by health literacy.

Methods:

Patients from the medical ward of an inner‐city hospital were interviewed during their hospitalization to assess personal characteristics and health literacy, using the Rapid Estimate of Adult Literacy in Medicine (REALM). Scores of 0–44 indicate inadequate health literacy, and scores of 45–66 indicate marginal or adequate health literacy. Approximately 2 weeks after discharge, patients completed by telephone the 27‐item Interpersonal Processes of Care in Diverse Populations (IPC) questionnaire. Using the IPC's 5‐point Likert scale, patients rated the clarity and quality of their communication with health care providers during the hospitalization along the following 8 domains: general clarity, responsiveness to patient issues, explanation of patients problems, explanation of processes of care, explanation of self‐care after discharge, empowerment, decision‐making, and consideration of compliance. Descriptive statistics and bivariate analyses were performed.

Results:

A total of 84 patients completed both the in‐hospital and telephone interviews. Subjects had a mean age of 55 years and were primarily African American (88%) and male (54%). Most (62%) had a high school education, although 44% had inadequate health literacy. Overall, patients gave the lowest ratings to communication that related 1o consideration of compliance, explanation of self‐care after discharge, and decision‐making (Table 1). Compared with patients with marginal or adequate health literacy, patients with inadequate health literacy gave significantly lower ratings on the domains of general clarity, responsiveness to patient issues, and explanation of processes of care (Table 1).

Table 1. Interpersonal Processes of Care Overall and by Health Literacy

Conclusions:

The areas of hospital communication rated lowest by patients pertained to decision‐making and postdischarge care. Patients with low health literacy also experienced lower quality and clarity of hospital communication along multiple domains. Given the association of poor in‐hospital communication with postdischarge adverse events and readmission, more attention to effective health communication is warranted in the hospital setting.

Author Disclosure:

S. Kripalani, none; C. Mugalla, none; R. Cawthon, none; T. Jacobson, none; V. Vaccarino, none.

To cite this abstract:

Kripalani S, Mugalla C, Cawthon R, Jacobson T, Vac‐carino V. Quality of Physician–Patient Communication During Hospitalization. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 60. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/quality-of-physicianpatient-communication-during-hospitalization/. Accessed November 17, 2019.

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