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Examining patient-centered vs. doctor-centered attitudes among Austrian general practitioners : A cross-sectional
Lisa Niehoff1, Erika Zelko2, Kathryn Hoffmann3
1Institute of General Practice, Johannes Kepler University Linz, Altenberger Straße 69, 4040, Linz, Austria. lisa.niehoff@jku.at.
Objective:
To investigate the relationship between patient load or time constraints and attitudes towards person-centered care vs. doctor or disease-centered care within the context of primary care and family medicine in Austria.
Methods:
A cross-sectional questionnaire-based study was conducted in Austria as part of the international Person-centered care Attitudes among European General Practitioners/Family Physicians (PACE GP/FP) study [1]. The primary analysis examined the association between continuous patient-practitioner orientation scale (PPOS) scores and self-reported patient load using multivariable linear regression adjusted for age, sex and perceived stress. For a secondary analysis, participants were assigned to one of three care-approach groups, based on PPOS scores (patient-centered, medium patient-centered and doctor/disease-centered) and compared regarding the self-reported number of patients seen per day using a Kruskal-Wallis test.
Results:
In multivariable linear regression analyses, higher patient load remained independently associated with lower continuous PPOS scores (B = -0.003, 95% CI -0.005 to -0.001, p = 0.002). In our sample, patient load differed significantly across the different care approaches, H(2) = 6.112, p = 0.047, η2 = 0.058. General practitioners (GPs) in the doctor/disease-centered group saw significantly more patients per day (median = 90, interquartile range, IQR = 68) compared to the patient-centered group (median = 50, IQR = 65). Additionally, a high workload, characterized by high clinical demands and time pressure, was the most commonly reported barrier for person-centered care in daily practice.
Conclusion:
Higher patient load was associated with a lower patient-centered orientation among Austrian general practitioners. Our findings suggest the need to address systematic factors contributing to time constraints and emphasize the importance of equipping general practitioners with the resources needed to integrate person-centered care into their practice.
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