Quality of hospital to community care transitions: The experience of minority patients

Abstract

Objectives. Care transitions are an especially vulnerable juncture in the course of patient care. Patients from ethnic minority populations face additional unique challenges during hospital to community care transitions due to language and cultural barriers, yet, this phenomenon is understudied. This study examines the quality of care transitions of minority patients (immigrants) versus the general population, and specifically assesses the association between in-hospital provider-patient communication and the quality of minority care transitions. Design. Prospective study of older hospitalized adults. Setting. A large teaching hospital. Participants. Participants (n = 385) were patients hospitalized for non-disabling medical conditions, from one of the two groups: the general Israeli population (Hebrew speakers) or immigrants from the former Soviet Union (Russian speakers). Main outcome measures. One-month phone follow-up assessed the quality of patients' transitional care using the care transitions measure. Results. Russian speakers rated their transitional care on average 10% lower than Hebrew speakers (54.4 versus 64.2, respectively, P = 0.002). On average, Russian speakers' ratings on the physician interpersonal-communication scale were significantly lower than Hebrew speakers' ratings. For Russian speakers, but not Hebrew speakers, the interpersonal physician communication scale was significantly positively associated with the quality of care transitions in multivariate analyses (P = 0.01), controlling for gender, education, economic status and length of stay. Conclusions. Minority patients experience lower quality of care transitions than the general population. Interpersonal physician- patient communication during the hospital stay is associated with better care transitions of ethnic minority patients and should be considered in efforts to improve the quality of minority patients' care transition processes. © The Author 2013. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved.