Assessing the longitudinal impact of physician-patient relationship on functional health

R. Henry Olaisen, Mark D. Schluchter, Susan A. Flocke, Kathleen A. Smyth, Siran M. Koroukian, Kurt C. Stange

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE Access to a usual source of care is associated with improved health outcomes, but research on how the physician-patient relationship affects a patient’s health, particularly long-term, is limited. The aim of this study was to investigate the longitudinal effect of changes in the physician-patient relationship on functional health. METHODS We conducted a prospective cohort study using the Medical Expenditure Panel Survey (MEPS, 2015-2016). The outcome was 1-year change in functional health (12-Item Short-Form Survey). The predictors were quality of physician-patient relationship, and changes in this relationship, operationalized with the MEPS Primary Care (MEPS-PC) Relationship subscale, a composite measure with preliminary evidence of reliability and validity. Confounders included age, sex, race/ethnicity, educational attainment, insurance status, US region, and multimorbidity. We conducted analyses with survey-weighted, covariate-adjusted, predicted marginal means, used to calculate Cohen effect estimates. We tested differences in trajectories with multiple pairwise comparisons with Tukey contrasts. RESULTS Improved physician-patient relationships were associated with improved functional health, whereas worsened physician-patient relationships were associated with worsened functional health, with 1-year effect estimates ranging from 0.05 (95% CI, 0-0.10) to 0.08 (95% CI, 0.02-0.13) compared with −0.16 (95% CI, −0.35 to −0.03) to −0.33 (95% CI, −0.47 to −0.02), respectively. CONCLUSION The quality of the physician-patient relationship is positively associated with functional health. These findings could inform health care strategies and health policy aimed at improving patient-centered health outcomes.

Original languageEnglish (US)
Pages (from-to)422-429
Number of pages8
JournalAnnals of family medicine
Volume18
Issue number5
DOIs
StatePublished - 2020

Keywords

  • Functional health
  • Impact
  • Medical Expenditure Panel Survey
  • Primary care
  • Relationship
  • United States

ASJC Scopus subject areas

  • Family Practice

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