Are patients' ratings of their physicians related to health outcomes?
Are patients' ratings of their physicians related to health outcomes?
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DOI：
10.1370/afm.267
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发表时间：
2005-05-01
影响因子：
4.4
通讯作者：
Epstein, RM
中科院分区：
文献类型：
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作者：
Franks, P;Fiscella, K;Epstein, RM
使用患者报告的观察性研究表明，医生的人际关系风格和患者的预后之间存在关联。这些协会可能的混淆还没有仔细investigated.METHODS约4,700名患者的96名医生完成了一项调查工具，其中包括报告的健康状况的变化，在过去的一年中，他们的医生的看法（满意度，信任，病人的知识，自主权的支持），社会人口和临床协变量。我们研究了患者对医生的看法和报告的健康状况变化之间的调整关系。使用多层次分析，然后，我们探讨了医生之间的差异，在病人的看法，他们的医生和这些差异是否解释了病人的看法和报告的健康状况changes.Results之间的关系有显着的调整关系，病人的看法，他们的医生和报告的健康状况的变化：更好的认知与健康状况下降的风险较小相关（校正比值比= 1.14; 95%置信区间[CI]，1.05-1.24; P
PURPOSE Observational studies using patient reports suggest associations between physician interpersonal styles and patient outcomes. Possible confounding of these associations has not been carefully examined.METHODS Approximately 4,700 patients of 96 physicians completed a survey instrument that included reported health status changes during the previous year, perceptions of their physician (satisfaction, trust, knowledge of patient, and autonomy support), and sociodemographic and clinical covariates. We examined the adjusted relationship between patient perceptions of their physicians and reported health status changes. Using multilevel analyses, we then explored differences among physicians in patient perceptions of their physicians and whether these differences were explained by the relationship between patient perceptions and reported health status changes.RESULTS There were significant adjusted relationships between patient perceptions of their physician and reported health status changes: better perceptions were associated with a smaller risk of health status decline (adjusted odds ratio = 1.14; 95% confidence interval [CI], 1.05-1.24; P