Consumer Satisfaction with Primary Care Provider Choice and Associated Trust

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Abstract:

RESEARCH OBJECTIVE: Trust is important in medical relationships and for the achievement of better health outcomes. Developments in managed care in the recent years are believed to affect the quality of healthcare services delivery and to undermine trust in the healthcare provider. Physician choice has been identified as a strong predictor of provider trust but has not been studied in detail. Consumer satisfaction with primary care provider (PCP) choice includes having or not having physician choice. The study specific aims were: (1) to determine variables related to the factors: consumer characteristics and health status, information and consumer decision-making, consumer trust in providers in general and trust in the insurer, health plan financing and plan characteristics, and provider characteristics that may relate to PCP choice satisfaction; (2) to determine if the factors in aim one are related to PCP choice satisfaction; and (3) to analyze the association between PCP choice satisfaction and provider trust, controlling for potential confounders.

STUDY DESIGN: Cross-sectional survey

POPULATION STUDIED: Analyses were based on secondary data from a random national telephone survey in 1999, of residential households in the United States which included respondents aged over 20 and who had at least two visits with a health professional in the past two years. Among 1,117 eligible households interviewed (response rate 51.4%), 564 randomly selected to respond to insurer related questions made up the study sample. PRINCIPAL FINDINGS: Analyses using descriptive statistics, and linear and logistic regressions found continual effective care and interaction with the PCP beyond the medical setting most predictive of PCP choice satisfaction. Consumer characteristics, information and decision-making, provider characteristics and plan characteristics were factors found to predict consumers report of enough PCP choice. The information and decision making factor and provider characteristics factor were also found to predict provider trust and renamed continuity of care related and provider related in the revised framework. All in all, PCP competencies were significant in predicting PCP choice satisfaction and provider trust. CONCLUSIONS: It appeared that PCP choice satisfaction as a predictor of provider trust overlapped with other predictors of provider trust, such as communication between the provider and consumers. Although it may sound an aggressive task, to examine all the known predictors of provider trust in one study in the future. It may provide a holistic view of what's relatively important in predicting provider trust and in sustaining trust in the long term. Findings alluded to the importance of PCP competency training to include interpersonal (which also entails cultural) competency. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: This study has implications for the development of health services information. In the mist of growing consumerism, relevant, quality, cognitive, and accessible provider specific information would be helpful to the consumer. The goal of information is for consumers to make a fair choice, without too much complication to the decision making process. That is why it makes sense to study trust in provider specific information. Provision of useful information may be a better business strategy compared to hard core media marketing.