Article Figures & Data
Tables
- Table 1.
Characteristics of Patients and Physicians Enrolled and Not Enrolled in the Study
Characteristics Not Enrolled Enrolled SD = standard deviation; ADGs = ambulatory diagnostic groups; MCO = managed care organization. * Socioeconomic variables derived from patient Zip code linked to 1990 census data. † From the pool of 594 physicians, 297 were eligible for recruitment; family physicians were over-sampled; cooperation rate was 33.7%. Patient Number 483,094 121,806 Age, years (SD) 41.1 (11.2) 41.0 (11.0) Female sex, % 52.7 53.9 Median income, $ (SD)* 36,874 (10,160) 37,830 (10,683) High-school graduation, % (SD)* 63.8 (7.9) 64.8 (7.8) Any visit to a physician, % 82.5 83.1 Referred, % 25.6 25.7 Years enrolled in the MCO, No. (SD) 3.07 (1.12) 3.07 (1.12) ADGs, mean No. (SD) 2.99 (2.67) 3.02 (2.67) Physician Number 594 100† Specialty, family practice, % 24 47 Patients enrolled in the MCO, No. (SD) 813 (776) 1218 (758) Tercile of MPCC Score Standardized Expenditure Category Lowest Tercile* Middle Tercile†(95% CI) Highest Tercile†(95% CI) Note: Included are patients with at least some expenditures in each category. Adjusted percentage of standardized expenditures presented as terciles of MPCC scores. Analyses adjust (from claims data) for patient age, sex, Zip code-based socioeconomic status, ambulatory diagnostic groups, year, years of enrollment, and physician specialty. MPCC = Measure of Patient-Centered Communication. * Reference value. † As percentage of lowest tercile. Diagnostic testing costs 100 90.3 (84.3–96.9) 89.6 (83.9–95.6) Inpatient costs 100 103.7 (92.2–116.7) 98.9 (87.5–111.8) Total costs 100 96.3 (93.6–99.0) 96.8 (94.1–99.6)
Additional Files
Supplemental Appendix
Supplemental Appendix. Patient-Centered Communication and Diagnostic Testing: Detailed Methods.
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file, 3 pages, 80KB
The Issue in Brief
Patient Centered Communication and Diagnostic Testing
By Ronald Epstein, MD, and colleagues
Background: In patient-centered communication (PCC), doctors help patients feel understood by asking about their needs, perspectives and expectations, and patients are involved in decisions about their care. PCC can improve health and patient trust, but little is known about whether it affects health care costs. This study looked at the relationship between PCC and expenditures for diagnostic testing.
What this study found: Doctors who use a patient-centered communication style tend to have lower diagnostic testing expenditures and longer patient visits.
Implications
� Encouraging PCC would not necessarily drive up health care costs.
� PCC is important not only for its potential contribution to lowering diagnostic testing expenditure; it is also important for its positive effects on patients and their health.
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