Determinants and outcomes of patient-centered care

Patient Educ Couns. 2011 Oct;85(1):46-52. doi: 10.1016/j.pec.2010.08.001. Epub 2010 Aug 30.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Female
  • Health Services / statistics & numerical data
  • Humans
  • Male
  • Outcome Assessment, Health Care / methods*
  • Patient Satisfaction
  • Patient-Centered Care*
  • Physician-Patient Relations*
  • Practice Patterns, Physicians'*
  • Primary Health Care
  • Regression Analysis
  • Sex Factors
  • Socioeconomic Factors
  • United States