Jan. 6, 2009
Journal of General Internal Medicine
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High Medical Cost Burden, Patient Trust and Perceived Quality of Care by Peter J. Cunningham, Ph.D., HSC senior fellow
This study examines the association between high medical cost burdens and self-reported measures of patient trust of physicians and perceived quality of care. The rising cost of medical care threatens a vital aspect of the effective delivery of medical care-patient trust in their physician and continuity of care. This study found that patients with high medical cost burdens were more likely to question whether their physician would put their needs first, would refer them to specialists when needed and would perform unnecessary tests. Patients with high medical cost burdens also had more negative assessments of the thoroughness of care they receive from their physician. The association of high medical cost burdens with patient trust and perceived quality of care was greatest for privately insured people. This study was supported by the Commonwealth Fund.
Patient Experiences with Coordination of Care: The Benefit of Continuity and Primary Care Physician as Referral Source by Ann S. OMalley, M.D., M.P.H., HSC senior health researcher, and Peter J. Cunningham, Ph.D., HSC senior fellow
This study describes the extent to which people report that their care is coordinated
between their primary care physician (PCP) and specialists. Among adults who
have a PCP and who had at least one visit to another specialist in the past
year, less than half reported that their PCP always seemed informed about specialist
care received. Interpersonal continuity with the same PCP was associated with
better coordination of specialist care. In addition, when a visit to the specialist
was based on PCP referral (rather than some other source), significantly more
patients reported that their PCP was up-to-date about specialist care received
and that their PCP discussed with them what happened at their recent specialist
visit. Facilitating continuity between the patient and PCP and encouraging the
use of the PCP as the referral source would likely enhance care coordination.
This study was supported by the Robert Wood Johnson Foundation.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.