Patient-Centered Care is Associated with Decreased Health Care Utilization

Abstract

Purpose: This article uses an interactional analysis instrument to characterize patient-centered care in the primary care setting and to examine its relationship with health care utilization.Methods: Five hundred nine 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 their use of medical services and related charges monitored over 1 year.Results: Controlling for patient sex, age, education, income, self-reported health status, and health risk behaviors (obesity, alcohol abuse, and smoking), a higher average amount of patient-centered care recorded in visits throughout the 1-year study period was related to a significantly decreased annual number of visits for specialty care (P ‫؍‬ .0209), less frequent hospitalizations (P ‫؍‬ .0033), and fewer laboratory and diagnostic tests (P ‫؍‬ .0027). Total medical charges for the 1-year study were also significantly reduced (P ‫؍‬ .0002), as were charges for specialty care clinic visits (P ‫؍‬ .0005), for all patients who had a greater average amount of patient-centered visits during that same time period. For female patients, the regression equation predicted 15.47% of the variation in total annual medical charges compared with male patients, for whom 31.18% of the variation was explained by the average percent of patient-centered care, controlling for sociodemographic variables, health status, and health risk behaviors.Conclusions

Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

“…In line with studies elsewhere (11,14,(46)(47)(48)(49) it was found that inpatient treatment costs accounted for most of the overall expenditures, while the proportions differed by data source before (SR = 48.46% vs. AR = 69.46%), and after admission (SR = 52.57% vs. AR = 75.42%). Outpatient health service costs contributed the second largest share at T0 (SR = 33.83% vs. AR = 15.66%) while at T1, according to self-report, costs for medication and outpatient service were about equal (24.19% and 23.24% respectively).…”

“…Furthermore, costs might be saved and outcomes improved by substituting expensive inpatient services by appropriate outpatient and community services (1,(8)(9)(10). A study in a primary care setting found that patient-centered care contributes to decreasing the use of health care resources and associated costs (11). It has also been shown that the integration of substance abuse treatment or mental health care into primary care contributes to a decrease of inpatient days and total medical costs (12,13).…”

Medical Home Features of VHA Primary Care Clinics and Avoidable Hospitalizations

“…For example, studies on patient-centered care and acute care outcomes have had mixed results, 17,18 so certain patient-centered care activities may have more impact than others.…”

Association between quality of family planning services and client's satisfaction level in maternal and child health centers in Port Said city

“…[35] Since the 1980s, interest in the measurement of patients' satisfaction with their healthcare experiences has increased, following reports that high patient satisfaction is associated with better health outcomes. [41][42][43] This has not been universally accepted, however, Chang J. et al & Fisher E. et al and the debate over using patient satisfaction ratings as a quality-of-care marker continues. [44,45] The present study was also concerned about assessing client satisfaction concerning nurse's practice in family planning.…”