Abstract
Background
Patient activation describes an individual’s willingness and ability to take actions to independently manage health. Additional qualities of the relationship between a patient and provider may play a role in patient decision-making and motivation.
Aims
(1) To describe patient characteristics for groups who perceive different quality levels of PPR. (2) To examine the association and determine the effect of PPR on patient activation.
Methods
The Medicare Current Beneficiary Surveys was used to gather information on patient confidence, information seeking behaviors, and PPR. Scores for each variable set were categorized and described. Odds ratios were calculated using multinomial logistic regression models adjusting for sociodemographic variables.
Results
The study included 15,185 beneficiaries, 4198 (27.6 %) were categorized as low PPR, 6752 (44.5 %) were moderate PPR, and 4235 (27.9 %) high PPR. Adjusting for covariates, patients with moderate PPR and high PPR were more likely to have higher confidence when making healthcare decisions and exhibit information seeking behaviors compared to low PPR beneficiaries.
Discussion
This study supports the notion that patients with stronger relationships with their providers are also more active in healthcare decisions. After adjusting for gender, race, age, education, and income, high-quality PPR was still found to be associated with increased levels of activation in the Medicare population.
Conclusions
High-quality patient–provider relationships are associated with improved patient confidence and information seeking behaviors. Provider-centered strategies to improve patients’ connections to their physicians may motivate patients to engage in the healthcare process.
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References
Mikesell L (2013) Medicinal relationships: caring conversation. Med Educ 47:443–452. doi:10.1111/medu.12104
Weng H (2008) Does the physician’s emotional intelligence matter? Impacts of the physician’s emotional intelligence on the trust, patient-physician relationship, and satisfaction. Health Care Manag Rev 33:280–288
Dimatteo MR, Prince LM, Taranta A (1979) Patients’ perceptions of physicians behavior: determinants of patient commitment to the therapeutic relationship. J Community Health 4:280–290
Murphy J, Chang H, Montgomery JE et al (2001) The quality of physician-patient relationships: patients’ experiences 1996–1999. J Fam Pract 50:123–129
Parchman ML, Burge SK (2004) The patient-physician relationship, primary care attributes, and preventive services. Fam Med 36:22–27
Hibbard JH, Greene J (2013) What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff 32:207–214. doi:10.1377/hlthaff.2012.1061
Greene J, Hibbard JH (2012) Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med 27:520–526. doi:10.1007/s11606-011-1931-2
Lee Y, Kasper JD (1998) Assessment of medical care by elderly people: general satisfaction and physician quality. Health Serv Res 32:741–758
Tarn DM, Young HN, Craig BM (2012) Development of the patient approach and views toward healthcare communication (PAV-COM) measure among older adults. BMC Health Serv Res 12:289. doi:10.1186/1472-6963-12-289
U.S. Department of Health and Human Services (2015) Medicare Current Beneficiary Survey (MCBS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/MCBS.html. Accessed 12 Nov 2015
Parker JL, Regan JF, Petroski J (2014) Beneficiary activation in the medicare population. Medicare Medicaid Res Rev 4:1–14
Hibbard JH, Cunningham PJ (2008) How engaged are consumers in their health and health care, and why does it matter? Res Brief 8:1–9
Blustein J, Hanson K, Shea S (1998) Preventable hospitalizations and socioeconomic status. Health Aff 17:177–189. doi:10.1377/hlthaff.17.2.177
Isaacs SL, Schroeder SA (2004) Class—the ignored determinant of the nation’ s health. N Engl J Med 351:1137–1142
Adler NE, Newman K (2002) Socioeconomic disparities in health: pathways and policies. Health Aff 21:60–76. doi:10.1377/hlthaff.21.2.60
Powers DA, Yu X (2000) Statistical methods for categorical data analysis. Academic Press, San Diego
Liu X, Koirala H (2012) Ordinal regression analysis: using generalized ordinal logistic regression models to estimate educational data. J Mod Appl Stat Methods 11:242–254
Street RL, O’Malley KJ, Cooper LA et al (2008) Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity. Ann Fam Med 6:198–205. doi:10.1370/afm.821.Department
Cooper-Patrick L, Gallo JJ, Gonzales JJ et al (1999) Race, gender, and partnership in the patient-physician relationship. JAMA J Am Med Assoc 282:583–589
Kerse N, Buetow S, Mainous AG III et al (2004) Physician-patient relationship and medication compliance: a primary care investigation. Ann Fam Med 49:455–461. doi:10.1370/afm.139.INTRODUCTION
Franks P, Fiscella K, Shields CG et al (2005) Are patients’ ratings of their physicians related to health outcomes? Ann Fam Med 3:229–234. doi:10.1370/afm.267
Collins J (2001) Good to great. HarperCollins Publishers, New York
Thom DH, Wong ST, Guzman D et al (2011) Physician trust in the patient: development and validation of a new measure. Ann Fam Med 9:148–154. doi:10.1370/afm.1224
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All authors have no potential, perceived, or real conflicts of interests to disclose.
Statement of human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. This study protocol was approved by the University of Maryland, Baltimore Institutional Review Board on March 16, 2015.
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Informed consent was obtained from all patients by the Center for Medicaid Services (CMS) for being included in the study.
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Mattingly, T.J., Tom, S.E., Stuart, B. et al. Examining patient–provider relationship (PPR) quality and patient activation in the Medicare population. Aging Clin Exp Res 29, 543–548 (2017). https://doi.org/10.1007/s40520-016-0600-z
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DOI: https://doi.org/10.1007/s40520-016-0600-z