Patients' perceptions of safety if interpersonal continuity of care were to be disrupted

Health Expect. 2008 Dec;11(4):400-8. doi: 10.1111/j.1369-7625.2008.00503.x.


Objective: To determine if patients vary in perceptions of safety if interpersonal continuity were to be disrupted. If so, which characteristics are associated with feeling unsafe?

Background: The extent to which patients' preference for continuity with a personal physician is due to perceptions of safety is unclear.

Design: Observational study (Wisconsin Longitudinal Study Graduate and Sibling Survey).

Setting and participants: A total of 6827 respondents (most aged 63-66 years) who completed the 2003-06 survey round.

Main variables studied: Age, gender, marital status, education, health insurance type, illnesses, medications, length of relationship with provider and place, personality type, decision-making preference and trust in physician deliberation.

Main outcome measures: Safety perception when visiting another doctor or clinic if own doctor were not available.

Results: Twelve percent of respondents felt unsafe. After adjustment, as compared to those who felt safe, those who felt unsafe were more likely to be women (Odds ratio=1.65, 95% confidence interval=1.35-2.01), have more chronic conditions (1.27, 1.08-1.50) and have a longer relationship with a usual provider: 5-9 years (1.53, 1.11-2.10) 10-14 years (1.41, 1.02-1.95) and 15 or more years (1.62, 1.20-2.17) compared to 0-4 years. Those who preferred active participation in decision making and had trust in their physician were less likely to feel safe (1.63, 1.10-2.41).

Conclusions: Certain older adults perceive being unsafe if not seeing their usual physician. Further research should investigate reasons for perceptions of safety if continuity were disrupted and any implications for care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Continuity of Patient Care / statistics & numerical data*
  • Decision Making
  • Female
  • Health Care Surveys
  • Health Services Accessibility*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Participation / psychology
  • Physician-Patient Relations*
  • Quality Indicators, Health Care
  • Safety / statistics & numerical data*
  • Sex Factors
  • Socioeconomic Factors
  • Trust
  • Wisconsin