Patient-Focused Care: Patient Satisfaction and Health Outcomes

The effect of patient centeredness and a positive approach on patient satisfaction and health outcomes was evaluated in a UK study of 661 patients who completed a postconsultation questionnaire. The goals of the study were to determine the importance of patient centeredness to patient satisfaction, patient enablement, and symptom burden 1 month after the consultation. Independent predictors of high patient satisfaction were communication and partnership (p < 0.001) and a positive approach from the physician (p < 0.001). High patient enablement was independently predicted by the patients’ perception of the doctors’ interest in the effect of the problem on their lives (p = 0.001), health promotion (p < 0.001), and a positive approach (p < 0.001). At 1 month after consultation, patient-assessed symptom burden was improved with a positive approach (p = 0.004). The authors concluded that patients want a patient-centered, positive approach, and if they receive this approach they are more satisfied, have greater enablement, and have greater improvement in their symptom burden. sildenafil citrate pink

Stewart et al investigated patient-determined and observer-determined evaluations of patient cen-teredness on health outcomes. The investigators developed a scoring system to allow observers to evaluate physicians’ patient centeredness in relation to communication. This included exploration of both the patients’ disease and their experience of illness (their feelings, beliefs, impact on functioning, and expectations), understanding of the whole person, and the finding of common ground regarding man-agement. This scoring system and patients’ perceptions of the patient centeredness of their consultation were used to evaluate consultations between 39 family physicians and 315 patients. There was no relationship between the patient-centeredness score and any of the health outcomes evaluated (patients’ level of discomfort, diagnostic tests ordered, and referrals). However, patients’ evaluation of patient centeredness was associated with a lower postencounter level of concern (p = 0.02) as well as improvements 2 months after the consultation in the patients’ level of discomfort (p = 0.03) and their mental health assessment (p = 0.05). These results suggest that patients’ perceptions of quality in health care are relevant to health outcomes. In addition, patient-assessed patient centeredness was associated with fewer diagnostic tests (p = 0.05) and fewer referrals (p = 0.01) in the 2 months subsequent to the visit, indicating that patient-focused care does not equal more interventions and expense.

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