Do better quality consultations result in better health? Relationship between quality of consultations and health status of patients with non-acute abdominal complaints in general practice

Background. In theory, a positive relationship is expected between the qual ity of a consultation and a patient's subsequent health status. However, su ch a relationship has not yet been firmly established in daily practice. Objective. We aimed to study the relationship between the quality of the fi rst consultation in a new episode of non-acute abdominal complaints and sub sequent health status of patients in general practice. Methods. Quality scores for 743 consultations were calculated on the basis of review criteria developed by expert panels. Functional health status was measured by the SIP (Sickness Impact Profile) at baseline, and at 1 and 6 months after the consultation. Multilevel regression analysis was used to e xamine the relationship between the quality of consultations and health sta tus, and to identify factors of influence on this relationship. Results. In the majority of these patients (97%) health status improved reg ardless of consultation quality. In patients with malignant disease, a nd c hronic colitis, however, an association between consultation quality and su bsequent health status was found: in those with a high consultation quality score (>66-percentile) the health status deteriorated in the first month b ut improved over the following 5 months; in those with a low consultation q uality score (<33-percentile) it deteriorated continuously. Conclusion, For the great majority of patients we found no relation between the quality of consultation and health status. However, for a very small s ubgroup of patients there is proof of benefit from better quality consultat ions.