Determinants and outcomes of patient-centered care

作者：Bertakis Klea D^*; Azari Rahman

来源：Patient Education and Counseling, 2011, 85(1): 46-52.

DOI：10.1016/j.pec.2010.08.001

• Patient-centered care
• Healthcare utilization
• Patient gender differences
• Patient satisfaction

Objective: This paper defines an interactional analysis instrument to characterize patient-centered care and identify associated variables.
Methods: In this study, 509 new adult patients were randomized to care by family physicians and general internists. An adaption of the Davis Observation Code was used to measure a patient-centered practice style. The main outcome measures were visit-specific satisfaction and healthcare resource utilization.
Results: In initial primary care visits, patient-centered practice style was positively associated with higher patient self-reported physical health status (p = 0.0328), higher educational level (p = 0.0050), and non-smoking status (p = 0.0108); it was also observed more often in the interactions of family physicians compared to internists (p = 0.0003). Controlling for patient sociodemographic variables, self-reported health status, pain, health risk behaviors (obesity, alcohol abuse, and smoking), and clinic assignment, patient satisfaction was not related to the provision of patient-centered care. Moreover, a higher average amount of patient-centered care recorded in visits throughout the one-year study period was significantly related to lower annual medical charges (p = 0.0003).
Conclusions: Patient-centered care was observed more often with family physician caring for healthier, more educated patients, and was associated with lower charges.
Practice implications: Reduced annual medical care charges are an important outcome of patient-centered medical visits.

• 出版日期2011-10