Global Patient-Doctor Communication Report 2011 FINAL

Doctor - Patient
Global Communication Performance
Insights from the Worldwide Independent Network (WIN™) of Market Research
Fall, 2011
1
Contents
1. Background & Research
3
2. Context and Methodology
4
3. Key Findings
6
4. Communication Assessment Tool
7
5. Medication Usage
2
10
1. Background & Research
Background
WIN™, the Worldwide Independent Network of Market Research, the largest
independent organization of Market Research firms with members in 64
countries, prepared this landmark review of physician-patient communication.
Research
Physician-Patient communication critically influences the effectiveness of
medical education initiatives, treatment decisions and patient compliance to
recommended treatments.
WIN™ conducted this ground-breaking study on physician-Patient
communication throughout the world to provide the healthcare stakeholders
with a better understanding on how patients perceive communication skills of
their doctor, how patients engage their physician, how treatment choices are
influenced, the frequency and preferred modes of interaction and sources of
influential information.
3
2. Context and Methodology
Methodology and Geographical distribution:
In total, the study was carried out in 39 countries. In each country, the most appropriate interviewing methodology
was used given local conditions.
Fieldwork dates:
Fieldwork was conducted between July 19th 2011 and October 3rd 2011.
Sample:
The total size of the sample is 31 577 cases representative of 1 938 990 516 people.
Sample in each country is probabilistic and was designed to represent the general adult population.
General coverage of the sample is as follows:
75% national
25% urban
Weighting:
The data was weighted in two steps to obtain representation by country and worldwide. The data was first weighted
to generate data representative of the general population for each country. A second weight, according to the size
of the population surveyed, was then applied to obtain global and regional totals.
The margin of error per country is between +/- 2.34% and 5.66%, 19 times out of 20.
The table on the next page presents a summary of the methodology used in each country to conduct this survey.
Each sample is representative of its country’s population in terms of socio-demographic variables. Sample sizes
ensure accurate generalizations to the total population and allow a very precise interpretation of the results.
4
2. Context and Methodology…
Country
Firm
Australia
MPG LLC (Marketing Professional
Group)
Colmar Brunton
Austria
Armenia
Method
Sample Total Population
Sampling Method
Sample
Population represented
Age
representation
by sample
Weighting variables
Fieldwork dates
Gender, Age
Aug. 12-25
Margin of
error +/-
CATI
1003
7 953 438
Quota Sampling
National
3 356 000
18+
Online
910
20 000 000
Stratified
National
18 200 000
18+
Gallup Austria
Face to Face
532
8 400 000
Random quota sampling
National
7 300 000
14+
Bosnia
Brazil
Mareco Index Bosnia
Ibope Inteligencia
CATI
750
Face to Face 1410
3 850 000
190 000 000
Multistage random sample
Probabilistic
National
National
2 950 000
141 248 576
15+
16+
Bulgaria
BBSS
Face to Face
633
7 300 000
Random
National
6 500 000
18+
Online
1004
33 739 900
Random
National
24 750 000
18+
CATI
473
15 116 435
Urban
5 408 150
18-60
Online
400
1 300 000 000
Random
Random Sampling with online Panel
(Shanghai, Beijing and Guangzhou)
Urban
51 520 000
15+
No
Aug. 11-17
4.90%
CATI
612
44 000 000
Urban
13 826 630
18-65
No
Aug. 23-29
3.96%
Canada
Leger Marketing
Chile
IBOPE Inteligencia Chile
China
WisdomAsia
Colombia
CNC (Centro Nacional de Consultoria)
Czech
Republic
Denmark
Finland
DMA Research
Taloustutkimus Oy
Online
Online
France
BVA
Germany
Greece
Hong Kong
Iceland
India
Produkt+Markt
Centrum S.A
Consumer Search
Capacent
DataPrompt
Ireland
Red C Research
Two-stage design applied simple random sampling
Gender, Age, Region
Aug. 4-10
Gender, Age,
Region,Employment,
Jun. 20 - Aug. 3
Income
No
Jul. 19 - Aug. 5
Gender Age, Employment
Aug. 11-15
Gender, Age, Region, Type
Jul. 28-Aug,04
of settlement
Gender, Age, Region,
Aug. 8-15
language
Gender, Age, Location
Aug. 19- Sep. 5
Italy
Doxa
882
60 300 000
Random
National
50 000 000
Japan
Kenya
Lebanon
Luthuania
NRC (Nippon Research Center )
Infinite Insight
Reach
UAB RAIT
Online
1000
Face to Face 1003
CATI
1000
Face to Face 703
126,475,664
38 610 097
3 759 136
3 200 000
Random
Random
Random
Random Probilty Routine
National
National
National
National
99,604,610
26 254 865
2 781 760
2 625 400
Macedonia
BRIMA
Face to Face
2 052 722
Multi stage stratified random probability
National
1 689 265
Pakistan
Gallup Pakistan
Face to Face 1752
187 342 721
Stratified Probability Sampling
National
88 000 000
Palestine
PCPO
Face to Face
992
4 170 000
Random
National
1 876 500
Gender, Age, Region, Size of
18+
Community
18+
No
15+
Gender, Age, Region
Gender, Age, Region,
18+
Occupation
18-70
Gender, Age, Region
18-74
Region
15+
Gender, Age
16+
Gender, Age, Region
18+
No
Gender, Age, Social class
18+
and Regio.
Gender, Age, Region, Size of
18+
Community, Occupation
18-79
No
18+
No
18+
No
15-74 Gender, Age, Education
Gender, Age, Region size,
15+
Nationality
Gender, Age, Region, Type
18+
of settlement
18+
No
Peru
Datum
Face to Face
918
27 412 157
probabilistic, multistage stratified allocation
Urban
16 085 385
18-69
Poland
Romania
Russia
Saudi Arabia
Mareco
TNS CSOP
Romir
PARC
Face to Face 305
Face to Face 750
Online
1180
CATI
1155
38 200 000
21 431 298
143 000 000
27 000 000
Urban
National
Urban
Urban
5 100 000
18 190 003
69 000 000
13 000 000
South Africa
TRS (Topline Research Solutions)
Face to Face
400
49 320 000
Korea
Sweden
Swizterland
Tunisia
USA
Gallup Korea
CMA Research
Isopublic
EMRHOD
TRiG
Online
500
Online
1049
Face to Face 343
CATI
600
Online
1002
49 773 145
9 446 812
7 870 134
9 910 872
313 232 044
Stratified random
Stratified Probability Sampling
Random
Random
Random
(Johannesburg, Durban, Capetown )
Random Soft Quota
Statified
Random-quota
Stratified (governorates are strata)
Random
5
Mareco Ltd.
Face to Face 1000
10 224 626
Random route sampling
National
8 392 530
510
522
5 600 000
5 385 000
Random
Random
National
Nationl
4 200 000
4 577 250
Online
999
65 000 000
Quota Method
National
50 700 000
Online
CATI
CATI
Online
CATI
1006
300
800
717
803
81 800 000
10,961,758
7 100 000
320 000
1 210 193 422
National
Urban
National
National
Urban
56 500 000
6,351,506
6 130 300
247 437
963 600 000
CATI
839
4 580 000
Random
Statified
Random quota sampling
Random from our Web-panel
Random
Random digital dial including both
landline and mobile numbers
National
3 203 814
CATI
820
Urban
33 819 800
National
National
National
National
National
40 359 211
7 250 000
6 050 314
732 326
234 265 000
3.09%
3.25%
4.25%
3.58%
2.61%
3.90%
3.09%
4.51%
Aug. 4-15
3.10%
Aug. 12-15
Aug. 12-19
4.34%
4.29%
Aug. 1-4
3.10%
Jul. 25-Aug. 2
Jul. 18-Aug. 3
Jul. 30-Aug. 19
Aug. 10-18
Jul. 23-Aug. 19
3.09%
5.66%
3.46%
3.66%
3.46%
Aug. 8-10
3.38%
Jul. 21-24
3.30%
Aug. 11-15
Jul. 30-Aug. 8
Aug. 1-30
Aug. 1-18
3.10%
3.09%
4.38%
3.10%
Sept. 1-7
3.42%
Aug. 7-13
3.70%
Jul. 20-Aug. 15
2.34%
Gender, Region
Aug. 5-8
3.11%
15-65
18+
18-44
15+
No
Gender, Age, Region
Gender, Age, Region
No
Jul. 28-Aug. 2
Jul. 24-Aug. 1
Aug. 5-9
Jul. 19 - Aug. 24
3.23%
5.61%
3.58%
2.85%
18+
Gender, Age, Region
Jul. 29-Aug. 10
2.88%
18+
Gender, Age
Aug. 9-18
15-75
No
Aug. 9-13
15-74
Gender, Age, Region
Sept. 21-Oct. 3
18+
No
Aug. 22-27
18+ Gender, Age, Region, Race
Aug. 8-12
4.90%
3.03%
5.29%
4.00%
3.10%
3. KEY FINDINGS
Doctor-Patient Relationship Around the World
1. Communication effectiveness between
doctors and patients is related to being
compliant to taking prescribed
medication exactly as the doctor
directed.
2. Communication Assessment Tool (CAT™)
showed the communication between
doctor and patients is poor with a very
low score of 22%.
3. Asian markets are amongst the lowest
on communication effectiveness.
4. Directionally, comparing results from
prior years, communication
effectiveness between doctors and
patients on a global level trended
downward.
6
5. Doctor Communication Assessment Tool
Q. Thinking of your most recent visit, please rate the doctor’s communication with you.
CAT (Comunnication
Assessment Tool) Attributes
•Compared to last year, fewer citizens rated their doctor as
excellent this year in all of the 15 communication assessment
categories asked in the survey.
•Only a quarter or less rate their doctor as excellent in all of the
categories.
•Only 18% of respondents felt their doctor encouraged them to
ask question.
•With only 25%, “talk in terms I could understand” this is the
attribute that received the rating of excellent most frequently.
Key Finding:
A quarter or less of citizens rate
their doctor as excellent in all
of the categories.
2011
%
2010
%
25 32
24 30
Paid attention to me (looked at
me, listened carefully)
24 32
Treated me with respect
24 34
Greeted me in a way that made
me feel comfortable
23 29
Showed care and concern
23 30
Understood my main health
concerns
23 30
Discussed next steps, including
any follow-up plans
22 29
Gave me as much information as
I wanted
22 30
Let me talk without interruptions
22 31
Showed interest in my ideas
about my health
22 29
Spent the right amount of time
with me
22 30
Checked to be sure I understood
everything
21 27
Involved me in decisions as
much as I wanted
19 25
Encouraged me to ask questions
18 23
Total
22 29
Talked in terms I could
understand
How would you rate the care
provided by your doctor
*Global totals represent the averages of the top boxes scores in every surveyed
country
**In 2010, 23 countries participated in the survey. IN 2011, 39 countries
participated in the survey of which only 15 were recurrences from 2010.
7
5. CAT (Communication Assessment Tool)
Q. Thinking of your most recent visit, please rate the doctor’s communication with you.
Communication Assessment Tool
(CAT)
The Communication Assessment Tool
(CAT), developed by Makoul et al,
assesses patient perceptions of
physicians’
interpersonal
and
communication skills.
The CAT is a 15-item survey that is easily
administered in a paper-and-pencil
format, via the phone or Internet. The
CAT asks respondents to rate different
dimensions of the communication and
interpersonal skills of the physician
using a 5-point rating scale (1=poor,
2=fair,
3=good,
4=very
good,
5=excellent). Makoul et al found that
scoring the CAT based on the
proportion of items rated as excellent
was more meaningful than summarizing
the scores using means. Their
psychometric analysis of response
scales indicated that “a rating of
‘excellent’ was akin to ‘yes’, while even
‘very good’ was closer to ‘no’ than
‘yes.’” Data for the present study were
analyzed using the sum of the items
scored as excellent divided by the
number of items answered.*
Communication Assessment Tool (CAT)
•Overall, the CAT score in the 39 surveyed
countries is at a low of 22.
•The country with the highest CAT score is
Ireland with a score of 66. On the other
hand, Pakistan continues to record a low
CAT score with the lowest this year at 5
(Pakistan scored a 7 in 2010).
•Of the countries that participated in the
survey for the past two years, Austria’s
CAT score most decreased (-19) while Italy
(+10), Lebanon (+8), Korea (+7), China
(+7) most increased.
Key Finding:
On average, citizens
throughout the world give
their doctor a low CAT score.
*Source:
http://www.stfm.org/fmhub/fm2010/September/
Linda567.pdf (2010)
8
**In 2010, 23 countries participated in the survey. IN 2011, 39 countries
participated in the survey of which only 15 were recurrences from 2010.
Country
Ireland
Armenia
Chile
Macedonia
Bosnia
Australia
USA
Lebanon
Saudi Arabia
Canada
Sweden
Germany
France
Switzerland
Greece
Colombia
Iceland
South Africa
Bulgaria
Brazil
Lithuania
Russia
Tunisia
Korea
Austria
Denmark
Italy
Czech Rep.
Romania
Finland
India
Kenya
Palestine
Hong Kong
Poland
China
Japan
Peru
Pakistan
Total
2011
%
66
66
59
56
51
49
48 48 45 43 37
36
35 33
32
28
27 25
24 23 23
23 22
22 21 21
21 20
20
19
16 15
14
13
11
11 10 6
5
22 2010
%
NA
NA
NA
NA
NA
NA
52
40
51
47
NA
NA
39
NA
NA
NA
30
NA
25
30
NA
22
NA
15
40
NA
11
NA
NA
NA
17
NA
NA
NA
NA
4
11
NA
7
29
5. Global Communication Assessment Tool (CAT) Summary Summer 2010
Doctor-Patient Relationship around the world
High CAT scores
Citizens in Armenia, Australia, Bosnia, Canada,
Chile, Columbia, France, Germany, Greece, Ireland,
Lebanon, Macedonia, Saudi Arabia, Sweden,
Switzerland, and the USA are very satisfied with their
communication with their doctors with CAT scores
above average.
Key Finding:
Middle East
Americas
Africa
Asia
Total
9
Citizens in China, Hong Kong, India Japan,
Kenya, Pakistan, Palestine, Peru, Poland and
are the least satisfies with their doctor with
below average CAT scores.
38
Western Europe
Eastern Europe
Low CAT scores
42
31
23
Average CAT scores
21
16
22
Respondents in Austria, Brazil, Bulgaria, Czech
republic, Denmark, Finland, Iceland, Italy, Korea,
Lithuania, Romania, Russia, South Africa and
Tunisia have average CAT scores.
*The data for this graph is based on questions presented on slides 12. For the definitions of CAT (communication Assessment Tool) please refer to slide 12.
6. Medication Usage
Q. Do you currently have a medication that was prescribed by the doctor with whom you most recently met?
Q. How often would you say you have taken this prescription medication exactly according to the doctor’s direction?
•39% of individuals currently have a medication that was
prescribed by a doctor.
•Just over half (57%) of respondents take the medication
exactly according to the doctor’s directions and another
31% take the medication according to the doctor’s
direction most of the time.
•While Bulgarians are most likely to take prescription
medication exactly according to direction (91%), citizens
of Peru and Czech Republic are the least likely to do so
with 29% who answered that they only some of the time
or rarely take the medication according to direction.
Key Finding:
Just over half (57%) of citizens on
prescribed medication take it exactly
according to the doctor’s directions.
10
China
Korea
USA
Australia
Palestine
Canada
Austria
South Africa
Bosnia
France
Bulgaria
Colombia
Romania
Denmark
Germany
Sweden
Czech Rep.
Japan
Italy
Poland
Ireland
Macedonia
Lithuania
Hong Kong
Brazil
Tunisia
Switzerland
Iceland
Armenia
Pakistan
Lebanon
Saudi Arabia
Finland
Greece
Chile
Russia
Peru
India
Kenya
Total
Yes
%
All the time
%
80
68
63
62
58
57
57
55
53
53
52
52
50
50
50
49
48
48
48
47
47
47
46
44
43
41
40
39
39
38
38
37
37
35
35
32
31
26
24
39
43
36
70
67
34
72
68
58
84
73
91
70
75
79
64
75
44
55
76
77
78
85
72
41
78
50
68
61
43
41
74
58
73
68
65
50
53
44
60
57
Of those on
prescribed
medicaton,
taken
medication
according to
doctor's
direction
Most of the
time
%
55
54
21
30
28
23
32
25
7
23
6
15
18
18
32
18
26
42
20
19
13
10
19
43
14
27
23
34
18
47
16
20
24
7
21
42
18
34
19
31
Only some of the
time/Rarely
%
3
10
8
3
38
5
1
17
9
3
3
14
7
3
3
6
29
3
3
2
9
4
8
14
8
23
8
6
38
11
10
20
3
25
13
7
29
22
20
12