Patient choice. A randomized controlled trial of provider selection

Area of Science:

• Health Services Research
• Patient-Centered Care
• Healthcare Management

Background:

• Selecting a new primary care provider (PCP) is a critical decision for patients.
• Traditional assignment methods may not align with patient preferences, potentially impacting relationship quality.
• Optimizing the PCP selection process can enhance patient outcomes and provider retention.

Purpose of the Study:

• To assess the effectiveness of an intervention facilitating patient choice of a new primary care provider (PCP).
• To compare patient outcomes between an active choice intervention and standard PCP assignment.
• To evaluate the impact on patient satisfaction, trust, and PCP retention.

Main Methods:

• A randomized controlled trial was conducted involving 1090 patients aged 30+ who needed a new PCP.
• The intervention group received telephone or web-based information to aid provider selection.
• The control group received the usual method of PCP assignment.
• Outcomes were assessed via a mailed questionnaire one year after linkage with a new PCP.

Main Results:

• Patients in the intervention group were significantly more likely to feel they chose their PCP (78% vs. 22%).
• Intervention participants showed higher PCP retention rates at one year (93% vs. 69%) and greater overall satisfaction (67% vs. 57%).
• While trust was initially higher in the intervention group, it was not statistically significant after adjustments.

Conclusions:

• Actively involving patients in choosing their PCP leads to improved satisfaction and longer-term relationships.
• This patient-driven selection process offers mutual benefits for patients and healthcare providers.
• Further research should explore optimal information delivery and patient expectations in PCP selection.