Linking primary care performance to outcomes of care.

摘要: BACKGROUND Substantial research links many of the defining characteristics primary care to important outcomes; yet little is known about relative importance each characteristic, and several have not been examined. These analyses evaluate relationship between seven elements (accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment, trust) three outcomes (adherence physician's advice, patient satisfaction, improved health status). METHODS Data were derived from a cross-sectional observational study adults employed by Commonwealth Massachusetts (N = 7204). All patients completed validated questionnaire, Primary Care Assessment Survey. Regression methods used examine association characteristic (11 summary scales measuring 7 care) outcome. RESULTS Physicians' comprehensive ("whole person") knowledge patients' trust in their physician variables most strongly associated with adherence, was variable satisfaction physician. With other factors equal, adherence rates 2.6 times higher among whole-person scores 95th percentile compared 5th (44.0% vs 16.8% P < .001). The likelihood complete 87.5% for those 0.4% (P leading correlates self-reported improvements integration care, thoroughness physical examinations, communication, patients, CONCLUSIONS Patients' physicians' are care. results noteworthy context pervasive changes our nation's system that widely viewed as threatening quality physician-patient relationships.