Patients' preferences for technical versus interpersonal quality when selecting a primary care physician.
OBJECTIVE
To assess patients' use of and preferences for information about technical and interpersonal quality when using simulated, computerized health care report cards to select a primary care provider (PCP).


METHODS
Primary data collected from 304 adult consumers living in Los Angeles County in January and February 2003.


METHODS
We constructed computerized report cards for seven pairs of hypothetical individual PCPs (two internal validity check pairs included). Participants selected the physician that they preferred. A questionnaire collected demographic information and assessed participant attitudes towards different sources of report card information. The relationship between patient characteristics and number of times the participant selected the physician who excelled in technical quality are estimated using an ordered logit model.


RESULTS
Ninety percent of the sample selected the dominant physician for both validity checks, indicating a level of attention to task comparable with prior studies. When presented with pairs of physicians who varied in technical and interpersonal quality, two-thirds of the sample (95 percent CI: 62, 72 percent) chose the physician who was higher in technical quality at least three out of five times (one-sample binomial test of proportion). Age, gender, and ethnicity were not significant predictors of choosing the physician who was higher in technical quality.


CONCLUSIONS
These participants showed a strong preference for physicians of high technical quality when forced to make tradeoffs, but a substantial proportion of the sample preferred physicians of high interpersonal quality. Individual physician report cards should contain ample information in both domains to be most useful to patients.
Fung
Constance H
CH
Greater Los Angeles VA Healthcare Systems, Los Angeles, CA, USA.
Elliott
Marc N
MN
Hays
Ron D
RD
Kahn
Katherine L
KL
Kanouse
David E
DE
McGlynn
Elizabeth A
EA
Spranca
Mark D
MD
Shekelle
Paul G
PG
D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007255:Information Services; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care; D019984:Quality Indicators, Health Care; D018709:Statistics, Nonparametric