Related Experiment Video
Updated: Feb 3, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Patient Experience with Primary Care Physician and Risk for Hospitalization in Hispanics with CKD
Esteban A Cedillo-Couvert1, Jesse Y Hsu2, Ana C Ricardo1
1Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
Insights
A poor patient experience with primary care physicians is linked to increased hospitalizations in Hispanic individuals with chronic kidney disease (CKD). This highlights the importance of quality primary care for managing CKD outcomes.
Area of Science:
- Nephrology
- Health Services Research
- Health Outcomes
Background:
- Patient experience with primary care physicians (PCPs) impacts health outcomes but is understudied in chronic kidney disease (CKD).
- The growing Hispanic CKD population may face unique challenges to PCP experience due to language and cultural factors.
- Understanding PCP-patient interactions is crucial for improving care in this demographic.
Purpose of the Study:
- To evaluate the association between patient experience with PCPs and health outcomes in Hispanic individuals with CKD.
- To identify specific aspects of patient experience that correlate with hospitalization, end-stage kidney disease (ESKD), or death.
Main Methods:
- Prospective observational study of 252 English- and Spanish-speaking Hispanics with CKD (eGFR 20-70 ml/min/1.73 m²).
- Patient experience assessed using Ambulatory Care Experiences Survey subscales (communication, whole-person orientation, health promotion, interpersonal treatment, trust).
- Poisson and proportional hazards models used to analyze associations with hospitalization, ESKD, and all-cause death over a median follow-up of 4.8 years.
Main Results:
- Lower scores in communication quality, health promotion, interpersonal treatment, and trust were associated with a significantly higher risk of all-cause hospitalization.
- Adjusted rate ratios for hospitalization ranged from 1.31 to 1.57 for lower compared to higher subscale scores.
- No significant associations were found between patient experience subscales and incident ESKD or all-cause death.
Conclusions:
- A lower perceived quality of patient experience with PCPs is associated with an increased risk of hospitalization in Hispanic individuals with CKD.
- Improving communication, health promotion, interpersonal treatment, and trust in PCP interactions may help reduce hospitalizations in this population.
Background And Objectives:
In the general population, the quality of the patient experience with their primary care physician may influence health outcomes but this has not been evaluated in CKD. This is relevant for the growing Hispanic CKD population, which potentially faces challenges to the quality of the patient experience related to language or cultural factors. We evaluated the association between the patient experience with their primary care physician and outcomes in Hispanics with CKD.
Design, Setting, Participants, & Measurements:
This prospective observational study included 252 English- and Spanish-speaking Hispanics with entry eGFR of 20-70 ml/min per 1.73 m2, enrolled in the Hispanic Chronic Renal Insufficiency Cohort study between 2005 and 2008. Patient experience with their primary care physician was assessed by the Ambulatory Care Experiences Survey subscales: communication quality, whole-person orientation, health promotion, interpersonal treatment, and trust. Poisson and proportional hazards models were used to assess the association between the patient experience and outcomes, which included hospitalization, ESKD, and all-cause death.
Results:
Participants had a mean age of 56 years, 38% were women, 80% were primary Spanish speakers, and had a mean eGFR of 38 ml/min per 1.73 m2. Over 4.8 years (median) follow-up, there were 619 hospitalizations, 103 ESKD events, and 56 deaths. As compared with higher subscale scores, lower scores on four of the five subscales were associated with a higher adjusted rate ratio (RR) for all-cause hospitalization (communication quality: RR, 1.54; 95% confidence interval [95% CI], 1.25 to 1.90; health promotion: RR, 1.31; 95% CI, 1.05 to 1.62; interpersonal treatment: RR, 1.50; 95% CI, 1.22 to 1.85; and trust: RR, 1.57; 95% CI, 1.27 to 1.93). There was no significant association of subscales with incident ESKD or all-cause death.
Conclusions:
Lower perceived quality of the patient experience with their primary care physician was associated with a higher risk of hospitalization.
Related Concept Videos
00:59Hospitals-II
Nurses that work in...
01:13Patient-centered Care
01:28Hospitals-I
01:12Relative Risk
01:12What is an Experiment?
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...