title: The influence of cost containment strategies and physicians' financial arrangements on patients' trust and satisfaction.
abstract: Concerns have been raised about the potential for negative effects of health plans' cost containment strategies on the patient-physician relationship. We surveyed Minnesota patients with diabetes or hypertension (N = 595) and their physicians (N = 389) to assess the associations of gatekeeping, utilization profiling, and financial arrangements with patients' trust in and satisfaction with their physician. We found that patients of physicians exposed to various cost containment strategies were generally not less trusting in or less satisfied with their physicians than other patients. These results suggest that physicians may have managed potential conflicts to avoid compromising the patient-physician relationship.
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, MA, USA. keating@hcp.med.harvard.edu
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Landrum
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: Catherine
authors.initials: C
authors.lastname: Borbas
authors.forename: Edward
authors.initials: E
authors.lastname: Guadagnoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003363:Cost Control / Q000379:methods; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000191:economics; D012052:Reimbursement, Incentive; D035502:Trust