Patient–Doctor Connectedness and the Quality of Primary Care. Ann Intern Med. 2009;150:I-48. doi: 10.7326/0003-4819-150-5-200903030-00002
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Published: Ann Intern Med. 2009;150(5):I-48.
Common sense suggests that the quality of medical care would be better when a doctor knows a patient well and the patient sees the same doctor over time than when a patient sees several doctors who do not know the patient well. However, good studies are lacking to prove that care is better when a patient is connected to a specific doctor.
To see whether quality of care is better when patients and doctors are connected than when these connections are not present.
155 590 adults who had at least 1 visit to a doctor in a network of primary care practices.
The researchers used data from clinical systems to identify patients who received most of their primary care from a specific doctor or from different doctors in a specific practice. Other patients were considered not connected to either a physician or a practice; usually, these patients were transitioning out of the health care network. The researchers then looked for a relationship between “connectedness” and several measures of quality of care: cancer screening in eligible patients, diabetes monitoring and control in patients with diabetes, and cholesterol monitoring and control in patients with diabetes and heart disease.
About 60% of patients were connected to a doctor, about 34% were connected to a practice, and about 6% were not connected to a doctor or practice. Large differences in insurance status and racial and ethnic groups were found among patients were who were unconnected or connected to a physician or practice; unconnected patients were more likely to be uninsured and of an ethnic and racial minority group. Patients who were connected to a physician were most likely to receive recommended care, whereas patients connected to a practice were less likely to receive recommended care. The researchers did not assess outcomes in unconnected patients.
This study included only 1 primary care network and looked at only a few measures of quality of care.
Patients who see a specific doctor are more likely to receive recommended care than patients who are not connected to a specific doctor.
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