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Patient-centered communication and diagnostic testing.

Ronald M Epstein1, Peter Franks, Cleveland G Shields

  • 1Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA. Ronald_Epstein@urmc.rochester.edu

Annals of Family Medicine
|September 29, 2005
PubMed
Summary
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Patient-centered communication is linked to lower diagnostic testing costs, though visits may be longer. Further research is needed to confirm these findings on healthcare expenditures.

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.

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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.