Patient-Provider Communication Disparities by Limited English Proficiency (LEP): Trends from the US Medical Expenditure Panel Survey, 2006–2015

Abstract The number of patients in U.S. hospitals with limited English proficiency (LEP) is growing. There is a body of evidence that suggests that inadequate patient-provider communication is responsible for a range of adverse events, including death. In recognition of this, the Joint Commission has set standards requiring hospitals to address the communication needs of the diverse hospitalized population. Although the optimal approach for LEP patients would involve having certified interpreters at the bedside around the clock, this is unfortunately not practically or economically feasible. Speech-generating devices (SGDs) can offer patients a means of communicating with their caregivers and an opportunity to participate more actively in their care. The University of Iowa Assistive Devices Lab has developed a series of bilingual communication templates suited for use in acute and critical care settings. They developed these templates for use by LEP patients who are speakers of diverse languages, as well as by Deaf patients who use a sign language as their primary means of communication.

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Employment Outcomes Among Cancer Survivors in the United States: Implications for Cancer Care Delivery

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djaa084 ◽

2020 ◽

Author(s):

Janet S de Moor ◽

Erin E Kent ◽

Timothy S McNeel ◽

Katherine S Virgo ◽

Jennifer Swanberg ◽

...

Keyword(s):

United States ◽

Cancer Survivors ◽

Medical Expenditure Panel Survey ◽

Care Delivery ◽

The United States ◽

Medical Expenditure ◽

Panel Survey ◽

Part Time ◽

Patient Provider Communication ◽

National Prevalence

Abstract The national prevalence of employment changes after a cancer diagnosis has not been fully documented. Cancer survivors who worked for pay at or since diagnosis (n = 1490) were identified from the 2011, 2016, and 2017 Medical Expenditure Panel Survey and Experiences with Cancer supplement. Analyses characterized employment changes due to cancer and identified correlates of those employment changes. Employment changes were made by 41.3% (95% confidence interval [CI] = 38.0% to 44.6%) of cancer survivors, representing more than 3.5 million adults in the United States. Of these, 75.4% (95% CI = 71.3% to 79.2%) took extended paid time off and 46.1% (95% CI = 41.6% to 50.7%) made other changes, including switching to part-time or to a less demanding job. Cancer survivors who were younger, female, non-White, or multiple races and ethnicities, and younger than age 20 years since last cancer treatment were more likely to make employment changes. Findings highlight the need for patient-provider communication about the effects of cancer and its treatment on employment.

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Has the Quality of Patient–Provider Communication About Survivorship Care Improved?

Journal of Oncology Practice ◽

10.1200/jop.19.00157 ◽

2019 ◽

Vol 15 (11) ◽

pp. e916-e924 ◽

Cited By ~ 2

Author(s):

Ashish Rai ◽

Neetu Chawla ◽

Xuesong Han ◽

Sun Hee Rim ◽

Tenbroeck Smith ◽

...

Keyword(s):

Medical Expenditure Panel Survey ◽

Social Needs ◽

Medical Expenditure ◽

Provider Communication ◽

Survivorship Care ◽

Cancer Treatments ◽

Targeted Interventions ◽

Patient Provider Communication

PURPOSE: The aim of the current study was to assess whether the quality of patient–provider communication on key elements of cancer survivorship care changed between 2011 and 2016. METHODS: Participating survivors completed the 2011 or 2016 Medical Expenditure Panel Survey Experiences with Cancer Surveys (N = 2,266). Participants reported whether any clinician ever discussed different aspects of survivorship care. Responses ranged from “Did not discuss at all” to “Discussed it with me in detail”. Distributions of responses were compared among all respondents and only among those who had received cancer-directed treatment within 3 years of the survey. RESULTS: In 2011, the percentage of survivors who did not receive detailed instructions on follow-up care, late or long-term adverse effects, lifestyle recommendations, and emotional or social needs were 35.1% (95% CI, 31.9% to 38.4%), 54.2% (95% CI, 50.7% to 57.6%), 58.9% (95% CI, 55.3% to 62.5%), and 69.2% (95% CI, 65.9% to 72.3%), respectively, and the corresponding proportions for 2016 were 35.4% (95% CI, 31.9% to 37.8%), 55.5% (95% CI, 51.7% to 59.3%), 57.8% (95% CI, 54.2% to 61.2%), and 68.2% (95% CI, 64.3% to 71.8%), respectively. Findings were similar among recently treated respondents. Only 24% in 2011 and 22% in 2016 reported having detailed discussions about all four topics. In 2016, 47.6% of patients (95% CI, 43.8% to 51.4%) reported not having detailed discussions with their providers about a summary of their cancer treatments. CONCLUSION: Clear gaps in the quality of communication between survivors of cancer and providers persist. Our results highlight the need for continued efforts to improve communication between survivors of cancer and providers, including targeted interventions in key survivorship care areas.

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