Does patient-centered care improve provision of preventive services?

Flach, Stephen D.; McCoy, Kim; Vaughn, Thomas; Ward, Marcia M.; BootsMiller, Bonnie J.; Doebbeling, Bradley N.

doi:10.1111/j.1525-1497.2004.30395.x

Cited by 68 publications

(54 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8,21,22 Several other studies have found improvement in preventive services and utilization with increased continuity of care, but only Belardi et al have found an association between access improvements and continuity of care (and that was in a residency clinic). [23][24][25] Results show the importance of including a separate focus on continuity of care when working to improve access, which is what this medical group did in its access transformation. Some groups, however, appear to have created access changes in such a way that continuity would be likely to deteriorate by not allowing patients to preschedule follow-up visits.…”

Section: Discussionmentioning

confidence: 99%

Effect of Improved Primary Care Access on Quality of Depression Care

Solberg

Crain²,

Sperl-Hillen³

et al. 2006

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSE We wanted to determine whether a major improvement in access to primary care during 2000 was associated with changes in the quality of care for patients with depression.METHODS Health plan administrative data were analyzed by multilevel regression to compare the quality of care received by patients with depression between 1999 and 2001, a time without major changes in depression care guidelines. Approximately 6,000 patients with depression who received all care in a large multispecialty medical group during any single year were subjects for this study. Thirteen different quality measures assessed process quality under the dimensions of effectiveness, timeliness, safety, and patient-centeredness. RESULTSThe largest change was a reduction in the proportion of depressed patients with no follow-up visit in primary care after starting a new antidepressant medication: from 33.0% before a change in access to care to 15.4% afterward, P =.001. During the same period, continuity of care in primary care improved (>50% of primary care visits to 1 doctor increased from 67.3% to 74.0%, P = <.001), as did persistence of 6-month antidepressant medication (from 46.2% to 50.8%, P = <.001). Further analyses found that the latter change was primarily associated with the change in continuity of care. Measures of subspecialty mental health care worsened during this time.CONCLUSION Marked improvement in access to primary care for 1 year was associated with some improvement in primary care for patients with depression, but the mechanism appeared to be improved continuity. Those planning to implement advanced access to care need to do so in such a way that continuity of care is enhanced rather than harmed by the change. 1 This report identifi ed 6 domains or aims of quality: safety, timeliness, effectiveness, effi ciency, equity, and patient-centeredness, each of which had large gaps between "the care we have and the care we could have." Although the report identifi ed a whole series of recommendations to improve quality, it did not address the relationship between the different domains, and it is unclear whether improvements in any particular domain will improve others as well.Although the IOM reports dramatically raised the national awareness about quality, it is not clear that much has happened to change care since then, with the possible exception of what the IOM called "timeliness" ("reducing waits and sometimes harmful delays"). Recent articles suggest that many medical groups are making substantial improvements in access to primary care through using an advanced access model of patient scheduling or Second Generation Open Access. 2,3 In this approach, the goal is to offer patients an offi ce visit with the patient' s personal physician the same day the 70IMPROVED ACCESS AND DEPRESSION CARE patient requests one (if that physician is in the offi ce that day and if the patient wants an appointment that day).Although most reports about successful implementation of advanced access are either anecdotal or case studies,...

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Improved Primary Care Access on Quality of Depression Care

Solberg

Crain²,

Sperl-Hillen³

et al. 2006

The Annals of Family Medicine

View full text Add to dashboard Cite

show abstract

“…Finally, an excellent patient-physician rapport as well as continuity of care was correlated with improved preventive care delivery [60]. Two aspects of patient-centered care, effective communication and continuity of care, are especially important [45].…”

Section: Patient Centered Care -Clinical Conveniencementioning

confidence: 99%

Patient Centered Care - A Conceptual Model and Review of the State of the Art

Jayadevappa

Chhatre²

2011

TOHSPJ

116

View full text Add to dashboard Cite

Abstract:Background: Patient-centered care that encompasses informed decision making can improve treatment choice, quality of care and outcomes. Patient-centered care recognizes the need for major changes in the process of care that arranges health care system around the patient.Objective: Study objective was to evaluate and discuss the interplay of components of patient-centered care by developing a conceptual model of patient-centered care.Methods: Comprehensive literature review was conducted using Medline, CINAHL, and Cochrane databases. Included were English language studies addressing issues related to patient-centered-care and patient reported outcomes.Results: Though the concept of patient-centered care emerged in the early 50s, it exploded in the health care research policy arena exponentially in the late nineties. The conceptual model described here can aid objective and subjective evaluation of patient-centered care. As we strive to improve the quality of care, patient-centered care can play a pivotal role in this process. This however requires changes in our healthcare system so as to improve overall quality of care by minimizing wasteful health resource consumption. Conclusions:With healthcare costs projected to continue their rapid increase, the current paradigm of healthcare is unsustainable. More research is needed to explore the various attributes of patient-centered care, its acceptability, and comparative effectiveness in the healthcare arena.

show abstract

“…[34][35][36][37] A clinician engaging in patient-centered, shared decision making may be most likely to tailor specific behavioral recommendations for patients to consider, adjust the amount of information conveyed, and arrange referrals to appropriate external resources. Provider perceptions of low personal efficacy to influence weight loss, a lack of treatment efficacy and/or futility, and patient resistance to interventions all play potential roles in reducing provider involvement in obesity treatment.…”

Section: Discussionmentioning

confidence: 99%

Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions

et al. 2008

View full text Add to dashboard Cite

OBJECTIVE: To evaluate patient-provider agreement on whether weight and related behaviors were discussed during routine visits. DESIGN:Post-visit survey assessments of patients and providers. PARTICIPANTS:Obese patients make up the majority of all patients seen in primary care (PC). The patients and physicians were recruited at the time of PC visits. MEASUREMENTS AND MAIN RESULTS:Percent patient-physician agreement and patient, provider and practice characteristics associated with agreement. Patients (456) and physicians (30) agreed about whether or not they discussed weight, physical activity (PA), and diet for 61% of office visits. There was disagreement on one of the items (weight, PA, or diet) for 23% of office visits, and for 2 or more of the items for 16% of the visits. Agreement was relatively greater for discussing weight than for discussing diet or physical activity. Physicians reported discussing weight issues more often than did patients. Overall patient-physician agreement was 0.51-0.59 (weighted Kappa statistic). In a multivariate analyses of factors associated with patient-physician agreement, health insurance (odds ratio [OR]=3.67, p value= 0.002), physician description of patient weight status (OR=2.27, p value=0.002), patient report of how weight relates to health (OR=1.70, p value=0.04), and female patient gender (OR=1.62, p=value=0.02) were significantly related to agreement. CONCLUSIONS:Patients and providers disagreed about whether or not weight issues were discussed in a large number of primary care encounters in this study. Physicians may be able to improve care for their obese patients by focusing discussions on specific details of diet and physical activity behaviors, and by clarifying that patients perceive weight-related information has been shared.

show abstract

Does patient-centered care improve provision of preventive services?

Abstract: Improved communication between patients and providers, and continuity of care are associated with increased provision of preventive services, while other aspects of PCC are not strongly related to delivery of preventive services.

Cited by 68 publications

References 46 publications

Effect of Improved Primary Care Access on Quality of Depression Care

Effect of Improved Primary Care Access on Quality of Depression Care

Patient Centered Care - A Conceptual Model and Review of the State of the Art

Discussing Weight with Obese Primary Care Patients: Physician and Patient Perceptions

Contact Info

Product

Resources

About