title: Faithful patients: the effect of long-term physician-patient relationships on the costs and use of health care by older Americans.
abstract: OBJECTIVE
  This study examined the impact of duration of physician-patient ties on the processes and costs of medical care.
  
  
  METHODS
  The analyses used a nationally representative sample of Americans 65 years old or older who participated in the Medicare Current Beneficiary Survey in 1991 and had a usual source of care.
  
  
  RESULTS
  Older Americans have long-standing ties with their physicians; among those with a usual source of care, 35.8% had ties enduring 10 years or more. Longer ties were associated with a decreased likelihood of hospitalization and lower costs. Compared with patients with a tie of 1 year or less, patients with ties of 10 years or more incurred $316.78 less in Part B Medicare costs, after adjustment for key demographic and health characteristics. However, substantial impacts on the use of selected preventive care services and the adoption of certain healthy behaviors were not observed.
  
  
  CONCLUSIONS
  This preliminary study suggests that long-standing physician-patient ties foster less expensive, less intensive medical care. Further studies are needed to confirm these findings and to understand how duration of tie influences the processes and outcomes of care.
authors.affiliation: Division of General Medicine, Columbia College of Physicians and Surgeons, New York, NY, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Blustein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000191:economics*; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States