Length of patient-physician relationship and patients' satisfaction and preventive service use in the rural south: a cross-sectional telephone study.
BACKGROUND
Physicians and patients highly value continuity in health care. Continuity can be measured in several ways but few studies have examined the specific association between the duration of the patient-doctor relationship and patient outcomes. This study (1) examines characteristics of rural adults who have had longer relationships with their physicians and (2) assesses if the length of relationship is associated with patients' satisfaction and likelihood of receiving recommended preventive services.


METHODS
Cross-sectional telephone survey of health care access indicators of adults in selected non-metropolitan counties of eight U.S. predominantly southern states. Analyses were restricted to adults who see a particular physician for their care and weighted for demographics and county sampling probabilities.


RESULTS
Of 3176 eligible respondents, 10.8% saw the same physician for the past 12 months, 11.8% for the previous 13-24 months, 20.7% for the past 25-60 months and 56.7% for more than 60 months. Compared to persons with one year or less continuity with the same physician, respondents with over five years continuity more often were Caucasian, insured, a high school graduate, and more often reported good to excellent health and an income above 25,000 dollars. Compared to those with more than five years of continuity, participants with either less than one year or one to two years of continuity with the same physician were more often not satisfied with their overall health care (OR 2.34; OR 1.78), participants with less than one year continuity were more often not satisfied with the concern shown them by their physician (O.R. 1.90) and having their health questions answered, and those with one to two years continuity were more often not satisfied with the quality of their care (OR 2.37). No significant associations were found between physician continuity and use rates of any of the queried preventive services.


CONCLUSIONS
Over half of this rural population has seen the same physician for more than five years. Longer continuity of care was associated with greater patient satisfaction and confidence in one's physician, but not with a greater likelihood of receiving recommended preventive services.
Donahue
Katrina E
KE
Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA. kdonahue@med.unc.edu
Ashkin
Evan
E
Pathman
Donald E
DE
D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000592:standards / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000592:standards / Q000706:statistics & numerical data*; D015144:Southeastern United States