HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Related articles in AJPH Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weiss, L J Articles by Blustein, J Search for Related Content PubMed PubMed Citation Articles by Weiss, L J Articles by Blustein, J

Faithful patients: the effect of long-term physician-patient relationships on the costs and use of health care by older Americans.

L J Weiss and J Blustein

Division of General Medicine, Columbia College of Physicians and Surgeons, New York, NY, USA.

OBJECTIVES: This study examined the impact of duration of physician-patient ties on the processes and costs of medical care. METHODS: The analyses used a nationally representative sample of Americans 65 years old or older who participated in the Medicare Current Beneficiary Survey in 1991 and had a usual source of care. RESULTS: Older Americans have long-standing ties with their physicians; among those with a usual source of care, 35.8% had ties enduring 10 years or more. Longer ties were associated with a decreased likelihood of hospitalization and lower costs. Compared with patients with a tie of 1 year or less, patients with ties of 10 years or more incurred $316.78 less in Part B Medicare costs, after adjustment for key demographic and health characteristics. However, substantial impacts on the use of selected preventive care services and the adoption of certain healthy behaviors were not observed. CONCLUSIONS: This preliminary study suggests that long-standing physician-patient ties foster less expensive, less intensive medical care. Further studies are needed to confirm these findings and to understand how duration of tie influences the processes and outcomes of care.

Related articles in AJPH:

On nurses.

M Jenkins
AJPH 1998 88: 135-136. [PDF]  

This article has been cited by other articles:

				C.-J. Hsiao and C. Boult Effects of Quality on Outcomes in Primary Care: A Review of the Literature American Journal of Medical Quality, July 1, 2008; 23(4): 302 - 310. [Abstract] [PDF]

				S. L. Minden, D. C. Hoaglin, L. Hadden, D. Frankel, T. Robbins, and J. Perloff Access to and utilization of neurologists by people with multiple sclerosis Neurology, March 25, 2008; 70(13_Part_2): 1141 - 1149. [Abstract] [Full Text] [PDF]

				A. I. Flores, W. B. Bilker, and E. A. Alessandrini Effects of Continuity of Care in Infancy on Receipt of Lead, Anemia, and Tuberculosis Screening Pediatrics, March 1, 2008; 121(3): e399 - e406. [Abstract] [Full Text] [PDF]

				M.-J. Sepulveda, T. Bodenheimer, and P. Grundy Primary Care: Can It Solve Employers' Health Care Dilemma? Health Aff., January 1, 2008; 27(1): 151 - 158. [Abstract] [Full Text] [PDF]

				J. D. Goodson Unintended Consequences of Resource-Based Relative Value Scale Reimbursement JAMA, November 21, 2007; 298(19): 2308 - 2310. [Full Text] [PDF]

				R. Ionescu-Ittu MSc, J. McCusker MD DrPH, A. Ciampi PhD, A.-M. Vadeboncoeur MD, D. Roberge PhD, D. Larouche MSc, J. Verdon MD MSc, and R. Pineault MD PhD Continuity of primary care and emergency department utilization among elderly people Can. Med. Assoc. J., November 20, 2007; 177(11): 1362 - 1368. [Abstract] [Full Text] [PDF]

				F. D. Wolinsky, T. R. Miller, J. F. Geweke, E. A. Chrischilles, H. An, R. B. Wallace, C. E. Pavlik, K. B. Wright, R. L. Ohsfeldt, and G. E. Rosenthal An Interpersonal Continuity of Care Measure for Medicare Part B Claims Analyses J. Gerontol. B. Psychol. Sci. Soc. Sci., May 1, 2007; 62(3): S160 - S168. [Abstract] [Full Text] [PDF]

				T. Bodenheimer, R. A. Berenson, and P. Rudolf The Primary Care-Specialty Income Gap: Why It Matters Ann Intern Med, February 20, 2007; 146(4): 301 - 306. [Abstract] [Full Text] [PDF]

				S. H. Jee and M. D. Cabana Indices for continuity of care: a systematic review of the literature. Med Care Res Rev, April 1, 2006; 63(2): 158 - 188. [Abstract] [PDF]

				R. L. Ferrer, S. J. Hambidge, and R. C. Maly The Essential Role of Generalists in Health Care Systems Ann Intern Med, April 19, 2005; 142(8): 691 - 699. [Abstract] [Full Text] [PDF]

				J. W. Saultz and J. Lochner Interpersonal Continuity of Care and Care Outcomes: A Critical Review Ann. Fam. Med, March 1, 2005; 3(2): 159 - 166. [Abstract] [Full Text] [PDF]

				J. W. Mold, G. E. Fryer, and A. M. Roberts When Do Older Patients Change Primary Care Physicians? J Am Board Fam Med, November 1, 2004; 17(6): 453 - 460. [Abstract] [Full Text] [PDF]

				D. J. Palmisano, D. W. Emmons, and G. D. Wozniak Expanding Insurance Coverage Through Tax Credits, Consumer Choice, and Market Enhancements: The American Medical Association Proposal for Health Insurance Reform JAMA, May 12, 2004; 291(18): 2237 - 2242. [Abstract] [Full Text] [PDF]

				J. W. Saultz Defining and Measuring Interpersonal Continuity of Care Ann. Fam. Med, September 1, 2003; 1(3): 134 - 143. [Abstract] [Full Text] [PDF]

				P. A. Nutting, M. A. Goodwin, S. A. Flocke, S. J. Zyzanski, and K. C. Stange Continuity of Primary Care: To Whom Does It Matter and When? Ann. Fam. Med, September 1, 2003; 1(3): 149 - 155. [Abstract] [Full Text] [PDF]

				A. G. LAWTHERS, G. S. PRANSKY, L. E. PETERSON, and J. H. HIMMELSTEIN Rethinking quality in the context of persons with disability Int. J. Qual. Health Care, August 1, 2003; 15(4): 287 - 299. [Abstract] [Full Text] [PDF]

				K. Davis Commentary Med Care Res Rev, June 1, 2003; 60(2_suppl): 89S - 99S. [PDF]

				D. P. Gray, P. Evans, K. Sweeney, P. Lings, D. Seamark, C. Seamark, M. Dixon, and N. Bradley Towards a theory of continuity of care J R Soc Med, April 1, 2003; 96(4): 160 - 166. [Full Text] [PDF]

				K. Grumbach and T. Bodenheimer A Primary Care Home for Americans: Putting the House in Order JAMA, August 21, 2002; 288(7): 889 - 893. [Abstract] [Full Text] [PDF]

				T. G. Ferris, Y. Chang, D. Blumenthal, and S. D. Pearson Leaving Gatekeeping Behind -- Effects of Opening Access to Specialists for Adults in a Health Maintenance Organization N. Engl. J. Med., November 1, 2001; 345(18): 1312 - 1317. [Abstract] [Full Text] [PDF]

				M. S. Donaldson Continuity of Care: A Reconceptualization Med Care Res Rev, September 1, 2001; 58(3): 255 - 290. [Abstract] [PDF]

				D. A. Christakis, L. Mell, T. D. Koepsell, F. J. Zimmerman, and F. A. Connell Association of Lower Continuity of Care With Greater Risk of Emergency Department Use and Hospitalization in Children Pediatrics, March 1, 2001; 107(3): 524 - 529. [Abstract] [Full Text]

				J. M. Gill, A. G. Mainous III, and M. Nsereko The Effect of Continuity of Care on Emergency Department Use Arch Fam Med, April 1, 2000; 9(4): 333 - 338. [Abstract] [Full Text] [PDF]

				T. Bodenheimer, B. Lo, and L. Casalino Primary Care Physicians Should Be Coordinators, Not Gatekeepers JAMA, June 2, 1999; 281(21): 2045 - 2049. [Abstract] [Full Text] [PDF]

				D. A. Christakis, J. A. Wright, T. D. Koepsell, S. Emerson, and F. A. Connell Is Greater Continuity of Care Associated With Less Emergency Department Utilization? Pediatrics, April 1, 1999; 103(4): 738 - 742. [Abstract] [Full Text]

				J. M. Gill and A. G. Mainous III The Role of Provider Continuity in Preventing Hospitalizations Arch Fam Med, July 1, 1998; 7(4): 352 - 357. [Abstract] [Full Text] [PDF]

				M. A. Bowman and D. E. Nicklin New Developments in Family Medicine JAMA, May 13, 1998; 279(18): 1437 - 1438. [Full Text] [PDF]

				R. A. Rosenblatt, L. G. Hart, L.-M. Baldwin, L. Chan, and R. Schneeweiss The Generalist Role of Specialty Physicians: Is There a Hidden System of Primary Care? JAMA, May 6, 1998; 279(17): 1364 - 1370. [Abstract] [Full Text] [PDF]

				DOES CONTINUITY OF CARE MATTER? Journal Watch (General), January 31, 1997; 1997(131): 4 - 4. [Full Text]