Dinkel A, Schneider A, Schmutzer G, Brähler E, Häuser W. Family physician-patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study.
Patient Educ Couns 2016;
99:1213-1219. [PMID:
26924610 DOI:
10.1016/j.pec.2016.02.009]
[Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE
To investigate the association between the quality of the family physician-patient relationship and frequent attendance of primary and specialist health care.
METHODS
Cross-sectional survey of a representative German population sample (N=2.266). Family physician-patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression.
RESULTS
Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02-2.00), not being in paid work (OR 1.58, CI 1.08-2.30), psychological distress (OR 1.14, CI 1.07-1.22), somatic symptoms (OR 1.07, CI 1.04-1.11), and physical comorbidity (OR 1.54, CI 1.36-1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04-1.20), somatic symptoms (OR 1.08, CI 1.04-1.11), and physical comorbidity (OR 1.69, CI 1.48-1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists.
CONCLUSIONS
The quality of the family physician-patient relationship is not independently associated with frequent attendance.
PRACTICE IMPLICATIONS
Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance.
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