Abstract
BACKGROUND:
Overall, poor physicianโpatient communication is related to postโdischarge adverse events and readmission. We analyzed patients' ratings of the quality of physicianโpatient communication during hospitalization and how this varies by health literacy.
METHODS:
Medical patients were interviewed during their hospitalization to assess personal characteristics and health literacy. After discharge, patients completed by telephone the 27โitem Interpersonal Processes of Care in Diverse Populations Questionnaire (IPC). Using the IPC, patients rated the clarity and quality of physicians' communication during the hospitalization along the following 8 domains: General clarity, Responsiveness to patient concerns, Explanation of patients' problems, Explanation of processes of care, Explanation of selfโcare after discharge, Empowerment, Decision making, and Consideration of patients' desire and ability to comply with recommendations.
RESULTS:
A total of 84 patients completed both the inโhospital and telephone interviews. Subjects had a mean age of 55, and 44% had inadequate health literacy. Overall, patients gave the poorest ratings to communication that related to Consideration of patients' desire and ability to comply with recommendations. Patients with inadequate health literacy gave significantly worse ratings on the domains of General clarity, Responsiveness to patient concerns, and Explanation of processes of care (P < 0.05 for each). In multivariable analyses, the relationship with General clarity did not persist.
CONCLUSIONS:
Physicians received relatively poor ratings on their Consideration of patients' desire and ability to comply with recommendations. Patients with inadequate health literacy experienced lower quality and clarity of hospital communication along multiple domains. More attention to effective health communication is warranted in the hospital setting. Journal of Hospital Medicine 2010;5:269โ275. ยฉ 2010 Society of Hospital Medicine.