FAITHFUL PATIENTS - THE EFFECT OF LONG-TERM PHYSICIAN-PATIENT RELATIONSHIPS ON THE COSTS AND USE OF HEALTH-CARE BY OLDER AMERICANS

Objectives. This study examined the impact of duration of physician-pa tient ties on the processes and costs of medical care. Methods. The an alyses used a nationally representative sample of Americans 65 years o ld or older who participated in the Medicare Current Beneficiary Surve y in 1991 and had a usual source of care. Results. Older Americans hav e long-standing ties with their physicians; among those with a usual s ource of care, 35.8% had ties enduring 10 years or more. Longer ties w ere associated with a decreased likelihood of hospitalization and lowe r costs. Compared with patients with a tie of 1 year or less, patients with ties of 10 years or more incurred $316.78 less in Part B Medicar e costs, after adjustment for key demographic and health characteristi cs. However, substantial impacts on the use of selected preventive car e services and the adoption of certain healthy behaviors were not obse rved. Conclusions. This preliminary study suggests that long-standing physician-patient ties foster less expensive, less intensive medical c are. Further studies are needed to confirm these findings and to under stand how duration of tie influences the processes and outcomes of car e.