Cindy Zhao1, Phillip Dowzicky1, Latesha Colbert1, Sanford Roberts1, Rachel R Kelz2. 1. Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA. 2. Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, PA. Electronic address: Rachel.Kelz@uphs.upenn.edu.
Abstract
BACKGROUND: No consensus exists on whether patient-provider race, gender, and language concordance provides benefits to surgical patients. We report a systematic review of the association between patient-provider concordance and patient preferences and outcomes in surgery. METHODS: A systematic review of the literature was performed in Medline and PubMed using defined search terms to identify studies related to patient-provider concordance in surgical patients. We included studies with full manuscripts published in English within the United States (1998 to July 2018). RESULTS: Out of 253 titles screened, 16 studies met inclusion criteria. Five studies had level 4 evidence and 11 studies had level 3 evidence. The majority of patients preferred providers with a similar background (n = 4/6). Race, gender, and language-concordance had no effect on adherence to provider recommendations (n = 3/3). No effect of race concordance on the quality of care was seen (n = 2/3). Gender concordance was associated with improved quality of care (n = 2/3). There were mixed effects of concordance on the effectiveness of communication (n = 2). CONCLUSION: Few studies examine patient-provider concordance. Most patients prioritize culturally, technically, and clinically competent providers over concordance. Future research is needed regarding the influence of concordance on patient outcomes in surgery within specific patient populations and clinical settings.
BACKGROUND: No consensus exists on whether patient-provider race, gender, and language concordance provides benefits to surgical patients. We report a systematic review of the association between patient-provider concordance and patient preferences and outcomes in surgery. METHODS: A systematic review of the literature was performed in Medline and PubMed using defined search terms to identify studies related to patient-provider concordance in surgical patients. We included studies with full manuscripts published in English within the United States (1998 to July 2018). RESULTS: Out of 253 titles screened, 16 studies met inclusion criteria. Five studies had level 4 evidence and 11 studies had level 3 evidence. The majority of patients preferred providers with a similar background (n = 4/6). Race, gender, and language-concordance had no effect on adherence to provider recommendations (n = 3/3). No effect of race concordance on the quality of care was seen (n = 2/3). Gender concordance was associated with improved quality of care (n = 2/3). There were mixed effects of concordance on the effectiveness of communication (n = 2). CONCLUSION: Few studies examine patient-provider concordance. Most patients prioritize culturally, technically, and clinically competent providers over concordance. Future research is needed regarding the influence of concordance on patient outcomes in surgery within specific patient populations and clinical settings.