Convenience or Continuity: When Are Patients Willing to Wait to See Their Own Doctor?

IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Gregory Shumer, Dongru Chen, John Holkeboer, Lauren Marshall, Devon Kinney, Ananda Sen, Michael Klinkman, Katherine J Gold
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Abstract

Purpose: Much of the literature on team-based primary care has focused on physician productivity, workload, and burnout. Less is known about how team-based care influences patient satisfaction and perceptions of the trade-off between continuity and access. This study assessed the preferences of family medicine patients for seeing their primary care physician (PCP) vs other team clinicians based on visit type and wait time.

Methods: Our cross-sectional online survey asked patients about their primary care clinics, PCP, portal use, self-reported health, and demographics. For multivariate analysis, we used weighted logistic regression analysis with survey data to calculate maximum likelihood estimates and converted these to odds ratios. We controlled for age and self-reported health as continuous variables and for demographics as categorical variables.

Results: We surveyed 4,795 adult patients and received responses from 2,516 (52.5%). More than one-half of patients preferred to see only their PCP for an annual checkup (52.6%), follow-up of a chronic condition (54.6%), or follow-up for a mental health condition (56.8%). Similarly, the majority of patients preferred to wait 3 to 4 weeks to see their PCP for issues possibly requiring a sensitive examination (68.2%), a new mental health concern (58.9%), or a new concern about a chronic condition (61.1%).

Conclusions: Our findings show that patients value having a PCP and maintaining continuity with their PCP. They also provide insight on when patients would prefer to wait to see their own PCP vs being seen more quickly by another clinician. As health care delivery and scheduling continue to evolve, these findings provide guidance for leaders in primary care.

方便还是连续性:病人什么时候愿意等着看自己的医生?
目的:大部分基于团队的初级保健的文献都集中在医生的工作效率、工作量和职业倦怠上。关于团队护理如何影响患者满意度和对连续性和可及性之间权衡的看法,我们所知甚少。本研究基于就诊类型和等待时间,评估了家庭医学患者对初级保健医生(PCP)与其他团队临床医生的就诊偏好。方法:我们的横断面在线调查询问了患者的初级保健诊所、PCP、门户网站使用情况、自我报告的健康状况和人口统计数据。对于多变量分析,我们使用调查数据加权逻辑回归分析来计算最大似然估计,并将其转换为比值比。我们将年龄和自我报告的健康状况作为连续变量,将人口统计数据作为分类变量进行控制。结果:我们调查了4,795名成年患者,收到了2,516例(52.5%)的回复。超过一半的患者更愿意只看他们的PCP进行年度检查(52.6%),慢性病随访(54.6%)或精神健康状况随访(56.8%)。同样,对于可能需要进行敏感检查的问题(68.2%)、新的精神健康问题(58.9%)或新的慢性疾病问题(61.1%),大多数患者更愿意等待3至4周去看他们的PCP。结论:我们的研究结果表明,患者重视PCP并保持其PCP的连续性。他们还提供了关于患者何时更愿意等待自己的PCP,而不是由其他临床医生更快地看到的见解。随着卫生保健服务和日程安排的不断发展,这些发现为初级保健的领导者提供了指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Family Medicine
Annals of Family Medicine 医学-医学:内科
CiteScore
3.70
自引率
4.50%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Annals of Family Medicine is a peer-reviewed research journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve.
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