چکیده (انگلیسی):

Background:Ethnic minorities report poorer evaluations of primary health care compared to White British patients.
Emerging evidence suggests that when a doctor and patient share ethnicity and/or language this is associated with
more positive reports of patient experience. Whether this is true for adults in English general practices remains to
be explored.
Methods:We analysed data from the 2010/2011 English General Practice Patient Survey, which were linked to data
from the NHS Choices website to identify languages which were available at the practice. Our analysis was restricted to
single-handed practices and included 190,582 patients across 1,068 practices. Including only single-handed practices
enabled us to attribute, more accurately, reported patient experience to the languages that were listed as being
available. We also carried out sensitivity analyses in multi-doctor practices.
We created a composite score on a 0-100 scale from sevensurvey items assessing doctor-patient communication.
Mixed-effect linear regression models were used to examine how differences in reported experience of doctor
communication between patients of different self-reported ethnicities varied according to whether a South Asian
language concordant with their ethnicity was available in their practice. Models were adjusted for patient characteristics
and a random effect for practice.
Results:Availability of a concordant language had the largest effect on communication ratings for Bangladeshis and
the least for Indian respondents (p < 0.01). Bangladeshi, Pakistani and Indian respondents on average reported poorer
communication than White British respondents [-2.9(95%CI -4.2, -1.6),-1.9(95%CI -2.6, -1.2) and-1.9(95%CI -2.5, -1.4),
respectively]. However, in practices where a concordant language was offered, the experience reported by Pakistani
patients was not substantially worse than that reported by White British patients (-0.2, 95%CI -1.5,+1.0), and in the case
of Bangladeshi patients was potentially much better (+4.5, 95%CI -1.0,+10.1). This contrasts with a worse experience
reported among Bangladeshi (-3.3,95%CI -4.6, -2.0) and Pakistani (-2.7,95%CI -3.6, -1.9) respondents when a concordant
language was not offered.
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* Correspondence:fa311@medschl.cam.ac.uk
1
Cambridge Centre for Health Services Research, Institute of Public Health,
Forvie Site, University of Cambridge School of Clinical Medicine, Box
113Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
Full list of author information is available at the end of the article
© 2015 Ahmed et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
Ahmedet al. BMC Family Practice (2015) 16:55
DOI 10.1186/s12875-015-0270-5
(Continued from previous page)
Conclusions:Substantial differences in reported patient experience exist between ethnic groups. Our results suggest
that patient experience among Bangladeshis and Pakistanis is improved where the practice offers a language that is
concordant with the patient’sethnicity.