{"doi":"10.1111/jgs.18411","title":"Association of perception of patient‐centered care with hearing loss by race","abstract":"Many healthcare organizations have adopted patient-centered approaches by implementing programs that prioritize patients' needs, values, and preferences into care,1 reflecting a growing recognition that patients should be active participants in their own care. Patient-centered care is associated with improved satisfaction and health outcomes.2 Hearing loss places considerable strain on patient–provider communication which is fundamental to patient-centered care. Moreover, race has previously been associated with poorer patient-centered care experiences yet minimal work evaluates this at the intersection of race and hearing loss.3, 4 The objectives of the present study are (1) to characterize the association of perception of patient-centered healthcare experiences among those with and without hearing loss, and (2) to explore whether race modifies the association. We pooled data of participants who completed at least one hearing measure from the Physical Measure module from the 2016 (n = 7674) and 2018 (n = 6839) waves of the Health & Retirement Study (HRS), a representative longitudinal panel study of Americans 50 years and older designed to understand health and well-being among aging and retired adults in the United States. The HRS captures information on income, work, physical/mental health, health care, and disability. The outcome of interest was perception of patient-centered care. Participants were asked: “Thinking about your experiences with the healthcare system over the past year, how often were your wishes for care taken into account [Always, Usually, Sometimes, Never]?” We derived a binary variable of optimal (always or usually) versus suboptimal (sometimes or never) perception of patient-centered care. Hearing was measured using the HearCheck Screener (Siemens, Germany), a screening tool that presents three tones at 1000 Hz (20, 35, 55 dB HL) and 3000 Hz (35, 55, 75 dB HL) in each ear (6 tones). Respondents indicated whether or not they heard each tone. Consistent with previous work, we defined hearing less than all 6 tones in the best ear as possible hearing loss.5, 6 Logistic regression was used to characterize the association of suboptimal perception of patient-centered care by hearing status. Covariates included: age, sex, race/ethnicity, marital status, educational attainment, insurance status, has usual source of care, and number of self-reported chronic comorbidities. To explore the presence of modification by race, the logistic regression was stratified by White and non-White groups. In the analytic sample, 28.5% reported suboptimal patient-centered care. Overall, 58.2% of respondents had possible hearing loss; however, there was a higher proportion of hearing loss among those reporting suboptimal patient-centered care (64.0% vs. 55.9%, p-value <0.001) (Table 1). In an adjusted model, individuals with hearing loss had 17% greater odds of having suboptimal perception of patient-centered care (odds ratio = 1.17, 95% CI = [1.07, 1.27]) relative to those without hearing loss (Table 2). Stratified models revealed a significant association between suboptimal patient-centered care and hearing loss among non-White participants (odds ratio = 1.21; 95% CI = [1.07–1.37]). However, no association was found among White individuals. In a sample of Americans over 50 years old, hearing loss was associated with higher odds of perceiving suboptimal patient-centered care during healthcare encounters. This may be attributable to hearing loss as a barrier to effective patient–provider communication which limits the ability to adequately express care preferences and participate in care decisions.7 Moreover, it is possible hearing loss among patients may contribute to implicit bias from clinicians who may avoid discussions to prevent communication breakdown or speak with companions rather than directly to adults with hearing loss.7 Following stratification, the association remained present only among non-White participants. It is ","journal":"Journal of the American Geriatrics Society","year":2023,"id":407081,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9543,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":264350,"name":"Esther S. Oh","orcid":"0000-0002-9638-5763","position":1,"is_corresponding":false},{"id":482270,"name":"Nicholas S. Reed","orcid":"0000-0003-0410-6067","position":2,"is_corresponding":false},{"id":648885,"name":"Grace Gahlon","orcid":null,"position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-19T01:21:07.213041Z","pmid":"37166077","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}