The influence of patient-clinician ethnocultural and language concordance on continuity and quality of care: a cross-sectional analysis

• Published in: CMAJ open Vol. 6; no. 3; pp. E276 - E284
• Main Authors: Waibel, Sina, Wong, Sabrina T, Katz, Alan, Levesque, Jean-Frederic, Nibber, Raji, Haggerty, Jeannie
• Format: Journal Article
• Language: English
• Published: Canada Joule Inc. or its licensors 01-07-2018
• ISSN: 2291-0026; 2291-0026
• DOI: 10.9778/cmajo.20170160

Concordance refers to shared characteristics between a clinician and patient, such as ethnicity or language. The purpose of this study was to examine whether patient-clinician concordance is associated with patient-reported continuity of care (relational, informational and management) and patient-reported impacts of care (quality and empowerment).
This is a secondary analysis of cross-sectional patient surveys that were administered across British Columbia, Manitoba and Quebec using random digit dialling. Participants were adults who spoke English, French, Mandarin, Cantonese or Punjabi and who had visited a primary care clinician in the previous 12 months (
= 3156). Patients self-identified as being of European, Chinese, South Asian and Indigenous descent. Outcome measures included patients' perceptions of continuity, quality and empowerment. Adjusted logistic regression models and odds ratio were generated.
More than 64% of non-Indigenous respondents reported ethnocultural concordance. Ethnocultural concordance was associated with higher odds of relational and management continuity. This same pattern held when there was both ethnocultural and language concordance. No association was found between language concordance and any outcome measure. Chinese participants reported lower quality (odds ratio [OR] 0.24, 95% confidence interval [CI] 0.12-0.48), as did South Asian participants (OR 0.17, 95% CI 0.09-0.31) than did participants of European descent.
Higher relational and management continuity is more likely with the presence of patient-clinician ethnocultural and language concordance. Lower continuity and quality reported by Chinese and South Asian particpants could indicate important health care disparities.