Communication with cancer survivors: Disparities by education level but not race in a majority-minority community

Purpose: Patient-provider communication (PPC) is an important component of optimal patient care. Many factors influence the quality of PPC among cancer patients, however, there are conflicting data on the impact of patient race and education level on PPC. We sought to assess the effect of race and education level on PPC among a multiracial cohort of cancer survivors. Methods: We conducted a survey of 360 cancer survivors. Data were collected on age, race, income, and education level. The survey assessed satisfaction with PPC and follow-up with cancer physician. Questions were answered on a 5-point response scale. We evaluated PPC using nonparametric analyses and built logistic regression models for satisfaction with follow-up care. Results Patients with a high school or lower education consistently rated questions of PPC more poorly than those who attained a higher level of education. No significant associations were detected between PPC and race. Results: for perceived quality of care showed a similar disparity by education level. High school educated patients reported significantly lower satisfaction with quality of follow-up care compared with patients who attained Graduate level education (OR 3.50, 95% CI 1.37-8.94). Conclusion: Our study demonstrated that education level, but not race, is associated with perception of communication and satisfaction with follow-up care. Patients who attained higher levels of education had higher PPC ratings and satisfaction with follow-up care. Our findings identify an opportunity for improvement in PPC through individualizing the delivery of health-related information with the goal of achieving optimal care of long-term cancer survivors.