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Titolo:
PHYSICIAN PRACTICE STYLES AND PATIENT OUTCOMES - DIFFERENCES BETWEEN FAMILY-PRACTICE AND GENERAL INTERNAL-MEDICINE
Autore:
BERTAKIS KD; CALLAHAN EJ; HELMS LJ; AZARI R; ROBBINS JA; MILLER J;
Indirizzi:
UNIV CALIF DAVIS,SCH MED,DEPT FAMILY & COMMUNITY MED,PRIMARY CARE CTR,2221 STOCKTON BLVD SACRAMENTO CA 95817 UNIV CALIF DAVIS,DEPT ECON DAVIS CA 00000 UNIV CALIF DAVIS,DIV STAT DAVIS CA 00000 UNIV CALIF DAVIS,DEPT INTERNAL MED DAVIS CA 00000
Titolo Testata:
Medical care
fascicolo: 6, volume: 36, anno: 1998,
pagine: 879 - 891
SICI:
0025-7079(1998)36:6<879:PPSAPO>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIAGNOSTIC METHODS; CARE; SPECIALTIES; RESOURCES; SYSTEMS;
Keywords:
PHYSICIAN PRACTICE STYLE; PATIENT HEALTH OUTCOMES; PATIENT SATISFACTION; PHYSICIAN-PATIENT RELATIONSHIP; INTERACTIONAL ANALYSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Physical, Chemical & Earth Sciences
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
K.D. Bertakis et al., "PHYSICIAN PRACTICE STYLES AND PATIENT OUTCOMES - DIFFERENCES BETWEEN FAMILY-PRACTICE AND GENERAL INTERNAL-MEDICINE", Medical care, 36(6), 1998, pp. 879-891

Abstract

OBJECTIVES. This study compared patient health status, patient satisfaction, and physician practice style between family practice and internal medicine. METHODS. New adult patients (n = 509) were prospectivelyand randomly assigned to family practice or internal medicine clinicsat a university medical center and followed for 1 year of care. Practice styles were characterized by the Davis Observation Code. Self-reported health status (Medical Outcomes Study, Short Form-36) and patientsatisfaction also were measured. RESULTS. There were no significantlydifferent changes in self-reported health status or patient satisfaction between family practice and internal medicine physicians during the course of the study. Family practice initial encounters, however, were characterized by a style placing greater relative emphasis on health behavior and counseling, whereas internists used a more technical style. Improved health status scores after treatment were predicted by apractice style emphasis on counseling, whereas improvements in patient satisfaction scores were predicted by a style of care stressing patient activation. Although this is the first known randomized trial studying this issue, the conclusions are limited by a 38% loss of patientsfrom enrollment to care and a loss of 18% at the 1-year follow-up evaluation. CONCLUSIONS. There were significant differences in practice styles between family physicians and internists; however, it was the physician's behavior, not specialty per se, that affected patient outcomes. A practice style emphasizing psychosocial aspects of care was predictive of improvements in patient health status, whereas a practice style emphasizing patient activation was predictive of improvements in patient satisfaction.

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Documento generato il 01/10/20 alle ore 01:28:58