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Patient-Centered Care Can Lower Medical Costs

Patients playing an active role can eliminate costly and unnecessary tests

Patient-centered care can lower costs and decrease the need for some healthcare services, according to a study published recently in the Journal of the American Board of Family Medicine.

Healthcare organizations face the challenge of providing high-quality medical care while containing costs. A patient-centered approach is under consideration as a model for high-quality care, but evidence that links patient-centered care to improved patient outcomes is lacking. A practice style that emphasizes patient activation has been associated with significantly lower primary care charges, however, and emerging evidence suggests that patient-centered communication results in less use of medical resources, such as tests. With the current study, the authors used a modified Davis Observation Code to measure a patient-centered practice style.

A total of 509 new adult patients were randomly assigned to receive care from family physicians or general internists. The main outcome measure was the use of medical services and related charges for one year. There were five categories: primary care clinic visits; specialty care clinic visits; emergency department visits; hospitalizations; and diagnostic services. Each office visit was videotaped and analyzed to measure the extent of discussion between patients and physicians. Factors associated with patient-centered care included discussion of family and social history, nutrition and exercise, the patient’s belief about his or her health, and counseling on the patient’s emotions and interpersonal relationships. The factors were compared with the patient's number of healthcare visits and charges throughout the year. The number of specialty-care visits, hospitalizations and diagnostic services, as well as total healthcare and specialty-care charges, were significantly lower among patients who received patient-centered care.

The authors write that the current study results extend previous studies, which had suggested that a patient-centered practice style decreases utilization of medical resources. The reason why a patient-centered approach may lead to lower medical resources usage is not fully understood, but it could be attributable to reduced patient anxiety because of their increased participation. The current study “provides compelling support for the use of a patient-centered approach in medical care and has obvious implications for a health care system being challenged to provide quality, personalized care in a cost-effective manner,” the authors conclude.

Source: Bertakis KD, Azari R. 2011. Patient-centered care is associated with decreased health care utilization. Journal of the American Board of Family Medicine 2011(24):229-239.