The patient-centered care and its relation to the outcomes of care in family medicine

Goranka Petricek, Mia Bajkovic, Gorka Vuletic, Venija Cerovecki, Zlata Ozvacic Adzic, Miroslav Hanzevacki

Keywords: patient-centered care, outcomes of care, family medicine

Background:
Patient-centered care (PCC) contributes to higher patient satisfaction, greater adherence to treatment, health outcomes improvement and a more rational use of health services.

Research questions:
To investigate the PCC level and its relation to the outcomes of care in family medicine (FM)

Method:
Prospective study was carried out on 120 unselected consecutive adult patients (18 years and over) attending routine consultations with selected six Croatian FM practices. The post-consultation questionnaire included items about the sociodemographic details, the 9-item Patient Perception of Patient-Centeredness (The 9-item PPPC) and the Short Form Health Survey. Patients were followed up after two months with the Outcomes in Relation to Impact on Daily Life (the ORIDL measure) and we reviewed notes after two months for reattendance, investigation, and referral. Statistic analysis was done using Statistika, version 7.1 statistic program, and values P<0.05 were considered statistically significant.

Results:
Patients mean age was 42.35 ± 14.46 years. Distribution of the 9-item PPPC average scores (on range 1-4) showed high scale range for all items: patient problem discussion (3.26±0.77), patient satisfaction with problem discussion (3.37±0.70), doctor listening (3.7±0.51), doctor problem explanation (3.56±0.59), respective roles discussion (3.28±0.77), doctor treatment explanation (3.54±0.61), doctor manageability of treatment for patient exploration (3.47±0.67), doctor patient understanding (3.76±0.47) and doctor personal or family issues that might affect patients’ health discussion (3.21±0.87). Patients with greater extent of the respective roles discussion were significantly less referred to the secondary care specialists (p<0.05). Patients with greater extent of the doctor personal or family issues that might affect patients’ health discussion were significantly less referred to the investigation (p<0.05)

Conclusions:
Significant relationships between PCC and number of patients’ investigation and referral observed in this study imply strengthening PCC could be helpful in a more rational use of health services.

Points for discussion: