Continuity of care and trust in one's physician: Evidence from primary care in the United States and the United Kingdom

Background and Objectives: Patients' trust in their physician to act in the ir best interest contributes to the effectiveness of medical care and may b e related to the structure of the health care system. This study explored t he relationship between continuity of care and trust in one's physician, pa rticularly in terms of differences between the United States and the United Kingdom (UK). Methods: We conducted a cross-sectional survey of adult pati ents (n = 418 in the United States and n = 650 in the UK) who presented in outpatient primary care settings in the United States (Charleston, SC and L exington, Ky) and in the UK (Leicester and Exeter) . Results: A high percen tage of both groups of patients reported having a usual place of care and d octor. A total of 69.8% of UK patients and 8.0% of US patients have had hei r regular physician for greater than or equal to 6 years. US patients (92.4 %) are most likely than UK patients (70.8%) to value continuity with a doct or. Both groups had high levels of trust in their regular doctor. Trust was related to one continuity measure (length of time for the relationship) bu t not to another (usual provider continuity index more than 1 year). In a m ultivariate model, country of residence had no independent relationship wit h trust, but continuity of care was significantly related. Conclusions: Hig her continuity is associated with a higher level of trust between a patient and a physician. Efforts to improve the relationship between patients and physicians may improve the quality and outcomes of care.