JABFM: Patient-centered care could mean lower annual charges
Patient-centered care was associated with decreased utilization of healthcare services and lower total annual charges, according to research that was published in the May-June edition of the Journal of the American Board of Family Medicine.
Reduced annual charges may be an important outcome of patient-centered medical visits, wrote Klea D. Bertakis, MD, MPH, and Rahman Azari, PhD, from the department of family and community medicine and the department of statistics at the Center for Healthcare Policy and Research at the University of California, Davis in Sacramento.
The researchers used an interactional analysis instrument to characterize patient-centered care in the primary care setting and to examine its relationship with healthcare utilization. In the study, 509 new adult patients were randomized to care by family physicians and general internists. The analysis instrument, an adaption of the Davis Observation Code, was used to measure a patient-centered practice style. The main outcome measures were the use of medical services and related charges monitored during one year, according to the authors.
In the one-year study period, the median percentage of patient-centered care during the primary care visits was 14.9 percent, the authors found. “It is interesting to note that the total annual charges for patients who had less patient-centered care had median total charges of $1,435, compared with $948 (51.3 percent more) for those patients whose healthcare was characterized as more patient-centered,” the authors wrote.
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 one-year study period was related to a significantly decreased annual number of visits for specialty care, less frequent hospitalizations and fewer laboratory and diagnostic tests, the authors found.
“Total medical charges for the one-year study were also significantly reduced, as were charges for specialty care clinic visits for all patients who had a greater average amount of patient-centered visits during that same time period,” wrote Bertakis and Azari.
“Although patient-centered care should not be promoted solely in the basis of cost considerations, it is important that its impact in healthcare costs be understood,” concluded the authors. “Patient-centered care may result in greater knowledge of the patient, greater trust between physician and patient, and diminished need for additional specialty referrals, diagnostic testing, and use of hospital care.”
Bertakis and Azari suggested that further studies should examine whether patient-centered care is associated with a decrease in discretionary medical expenses versus appropriate expenses. “Additional study is also needed to compare this instrument to other measures of patient-centered care,” they stated.
Reduced annual charges may be an important outcome of patient-centered medical visits, wrote Klea D. Bertakis, MD, MPH, and Rahman Azari, PhD, from the department of family and community medicine and the department of statistics at the Center for Healthcare Policy and Research at the University of California, Davis in Sacramento.
The researchers used an interactional analysis instrument to characterize patient-centered care in the primary care setting and to examine its relationship with healthcare utilization. In the study, 509 new adult patients were randomized to care by family physicians and general internists. The analysis instrument, an adaption of the Davis Observation Code, was used to measure a patient-centered practice style. The main outcome measures were the use of medical services and related charges monitored during one year, according to the authors.
In the one-year study period, the median percentage of patient-centered care during the primary care visits was 14.9 percent, the authors found. “It is interesting to note that the total annual charges for patients who had less patient-centered care had median total charges of $1,435, compared with $948 (51.3 percent more) for those patients whose healthcare was characterized as more patient-centered,” the authors wrote.
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 one-year study period was related to a significantly decreased annual number of visits for specialty care, less frequent hospitalizations and fewer laboratory and diagnostic tests, the authors found.
“Total medical charges for the one-year study were also significantly reduced, as were charges for specialty care clinic visits for all patients who had a greater average amount of patient-centered visits during that same time period,” wrote Bertakis and Azari.
“Although patient-centered care should not be promoted solely in the basis of cost considerations, it is important that its impact in healthcare costs be understood,” concluded the authors. “Patient-centered care may result in greater knowledge of the patient, greater trust between physician and patient, and diminished need for additional specialty referrals, diagnostic testing, and use of hospital care.”
Bertakis and Azari suggested that further studies should examine whether patient-centered care is associated with a decrease in discretionary medical expenses versus appropriate expenses. “Additional study is also needed to compare this instrument to other measures of patient-centered care,” they stated.