The Impact of Provider Demographics on Patients' Continuity of Care

The race concordance of providers to their patients impacts a patient's investment and agency in the patient-provider relationship. The mistrust of medicine within the African American population remains and patients feel unengaged in their care. Race concordant provider-patient rela-tionships would improve the equity of patient care in our clinic.

Study Overview

• Status: Unknown
• Conditions: Race Concordant Patient-provider Relationship; Race Discordant Patient-provider Relationship; Rate of No-show at Follow-up Visits
• Intervention / Treatment: Other: prospective, descriptive study via survey

Detailed Description

The patients of the obstetrics and gynecology resident clinic at Good Samaritan Hospital have a poor follow-up rate for their gynecologic and prenatal care visits. In addition, patients oftentimes voice frustration over the care that they receive and sometimes remark that they feel their provider was "racist." These patients often have complex social situations that cannot be solved in one office visit but perhaps the providers' ability to gain the trust of the minority patients is inadequate. The residents in the OB/GYN program are 80% white with no African American representation. If patients are unable to connect with caregivers due to cross-cultural differences, this could be remedied by training current residents in cross-cultural communication or re-cruitment of a resident class more representative of the majority African American patient population. This project will provide perspective on the minority patients' needs in the provider-patient relationship and allow providers to reexamine their ability to gain trust with the ultimate goal to increase follow-up rates. Follow-up rates for prenatal care are directly linked to improved maternal and fetal outcomes. The investigators goals are threefold: to gain clarity on whether or not a more diverse resident group would be helpful in gaining the trust of patients, to assess the current state of the well-established historical and generational mistrust of medical care by the African American patients of the clinic, and to explore how patient perception of their provider impacts their rate of follow up in the large community hospital clinic.

• Study Type: Observational
• Enrollment (Anticipated): 415

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Cincinnati, Ohio, United States, 45220
      • Recruiting
      • TriHealth Good Samaritan Hospital
      • Contact: Ganga Devaiah, MS; Email: ganga_devaiah@trihealth.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

• Patients of the Faculty Medical Center seeing OB/GYN residents
• Those requiring follow-up (less than 6 months)

Description

Inclusion criteria

• Female Patient seeing OB/GYN resident at FMC
• 18 years or older
• <36 weeks pregnant or GYN patient
• If GYN patient, must have problem requiring follow-up within 6 months
• Have not previously completed the survey

Exclusion criteria

• Less than 18 years of age
• High risk clinic patients (Tuesday afternoons)
• Patients without a follow-up less than 6 months as scheduled at check out

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Group 1 (provider-patient concordant)	Other: prospective, descriptive study via survey; Survey administered at check out.; Patient's rate of follow-up data gathered via chart review.
Group 2 (provider-patient discordant)	Other: prospective, descriptive study via survey; Survey administered at check out.; Patient's rate of follow-up data gathered via chart review.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient's rate of follow-up	Whether or not patient was present at their next scheduled GYN or OB follow-up appointment.	6 months

Collaborators and Investigators

• Sponsor: TriHealth Inc.
• Investigators: Principal Investigator: Nima Patel, MD, TriHealth Inc.

Study record dates

Study Major Dates

• Study Start (Actual): August 12, 2020
• Primary Completion (Anticipated): March 1, 2021
• Study Completion (Anticipated): March 1, 2021

Study Registration Dates

• First Submitted: March 17, 2020
• First Submitted That Met QC Criteria: March 17, 2020
• First Posted (Actual): March 19, 2020

Study Record Updates

• Last Update Posted (Actual): October 12, 2020
• Last Update Submitted That Met QC Criteria: October 9, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: 19-105

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No