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RESEARCH PRODUCT

Family physician–patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study

Elmar BrählerElmar BrählerAntonius SchneiderGabriele SchmutzerWinfried HäuserAndreas Dinkel

subject

AdultMalemedicine.medical_specialtyMultivariate analysisOffice VisitsHealth Services MisuseLogistic regressionCohort Studies03 medical and health sciences0302 clinical medicineGerman populationGermanySurveys and QuestionnairesHealth careHumansMedicine030212 general & internal medicineFrequent attendancePhysician-Patient RelationsUnivariate analysisbusiness.industryPhysicians FamilyGeneral MedicineMiddle AgedPatient Acceptance of Health Caremedicine.diseaseComorbidity030227 psychiatryPatient SatisfactionFamily medicineFemaleFamily PracticebusinessAttitude to HealthCohort study

description

Abstract Objective To investigate the association between the quality of the family physician–patient relationship and frequent attendance of primary and specialist health care. Methods Cross-sectional survey of a representative German population sample ( N  = 2.266). Family physician–patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression. Results Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02–2.00), not being in paid work (OR 1.58, CI 1.08–2.30), psychological distress (OR 1.14, CI 1.07–1.22), somatic symptoms (OR 1.07, CI 1.04–1.11), and physical comorbidity (OR 1.54, CI 1.36–1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04–1.20), somatic symptoms (OR 1.08, CI 1.04–1.11), and physical comorbidity (OR 1.69, CI 1.48–1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists. Conclusions The quality of the family physician–patient relationship is not independently associated with frequent attendance. Practice implications Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance.

https://doi.org/10.1016/j.pec.2016.02.009