The impact of patient-centered care on outcomes

. BACKGROUND We designed this observational cohort study to assess the asso ciation between patient-centered communication in primary care visits and s ubsequent health and medical care utilization. . METHODS We selected 39 family physicians at random, and 315 of their pati ents participated Office visits were audiotaped and scored for patient-cent ered communication. In addition, patients were asked for their perceptions of the patient-centeredness of the visit. The outcomes were: (1) patients' health, assessed by 3 visual analogue scale on symptom discomfort and conce rn; (2) self-report of health, using the Medical Outcomes Study Short Form- 36; and (3) medical care utilization variables of diagnostic tests, referra ls, and visits to the family physician, assessed by chart review. The 2 mea sures of patient-centeredness were correlated with the outcomes of visits, adjusting fur the clustering of patients by physician and controlling for c onfounding variables. . RESULTS Patient-centered communication was correlated with the patients' perceptions of finding common ground. In addition, positive perceptions (bo th the total score and the subscore on finding common ground) were associat ed with better recovery from their discomfort and concern, better emotional health 2 months later, and fewer diagnostic tests and referrals. . CONCLUSIONS Patient-centered communication influences patients' health th rough perceptions chat their visit was patient centered, and especially thr ough perceptions that common ground was achieved with the physician. Patien t-centered practice improved health status and increased the efficiency of care by reducing diagnostic tests and referrals.