Patient-centered communication and diagnostic testing

Area of Science:

• Health Services Research
• Health Economics
• Communication in Healthcare

Background:

• Patient-centered communication (PCC) is known to improve patient health outcomes and trust.
• Limited data exists on the impact of PCC on healthcare costs, particularly diagnostic testing expenditures.

Purpose of the Study:

• To investigate the association between patient-centered communication and diagnostic testing expenditures.
• To explore the relationship between physician interaction style and healthcare costs.

Main Methods:

• Observational cross-sectional study utilizing covert standardized patient visits.
• 100 primary care physicians from a managed care organization (MCO) in Rochester, NY, were included.
• Physician communication style was assessed using the Measure of Patient-Centered Communication (MPCC) based on audio recordings; expenditures were analyzed from MCO claims data.

Main Results:

• Physicians with lower MPCC scores (lowest tercile) exhibited significantly higher diagnostic testing expenditures (11.0% increase).
• Higher total standardized expenditures (3.5% increase) were observed for physicians with lower MPCC scores.
• The association between lower MPCC scores and increased expenditures remained significant after adjusting for visit length and patient detection.

Conclusions:

• Patient-centered communication is associated with reduced diagnostic testing expenditures.
• However, lower patient-centered communication was also linked to shorter visit lengths.
• Future randomized trials are recommended to validate these findings and inform the adoption of patient-centered approaches.