Man with sad face sitting with provider

One-third of adults 50 and older reported clinicians rarely took their care preferences into account, according to a newly released study. The survey of more than 36,000 people compared data from 2014, 2016 and 2018. LeadingAge, UMass Boston and the Center for Consumer Engagement in Health Innovation led the study with funding from the SCAN Foundation.

Although the study found little variation across age groups, it found significant differences in the way Blacks, Hispanics and lower-income seniors felt they were treated by providers. One in 4 Hispanic older adults and 1 in 6 Blacks said their care preferences were never taken into account, compared to 1 in 10 Whites who expressed similar concerns. Those with median incomes over $80,000 were nearly twice as likely to say that their preferences were considered compared to those with incomes below $50,000. 

“Race, income, and insurance status play a huge role in whether a person’s wishes are heard, and our research shows that when they are not, outcomes can be negative,” Marc Cohen, Ph.D., report co-author, said in a press release. “The data provide a critical benchmark for the state of patient-centered care before the pandemic. In coming months we will be able to see the impact of the first year of COVID on patient-centered care.”  

Person-centered care emphasizes the importance of understanding a patient’s preferences, values, goals and medical condition to effectively diagnose and treat illnesses. Researchers said the absence of person-centered care can lead to poorer health outcomes and higher medical costs, which can perpetuate disparities in care. 

Researchers also found that health insurance played a role in the perception older adults had on the care they were getting. Patients who were Medicaid and Medicare dually eligible were 7% less likely to report that their preferences weren’t taken in account.