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. 2005 Aug;40(4):957-77.
doi: 10.1111/j.1475-6773.2005.00395.x.

Patients' preferences for technical versus interpersonal quality when selecting a primary care physician

Constance H Fung  1 , Marc N Elliott, Ron D Hays, Katherine L Kahn, David E Kanouse, Elizabeth A McGlynn, Mark D Spranca, Paul G Shekelle
Affiliations

Patients' preferences for technical versus interpersonal quality when selecting a primary care physician

Constance H Fung et al. Health Serv Res. 2005 Aug.

Abstract

Objective: To assess patients' use of and preferences for information about technical and interpersonal quality when using simulated, computerized health care report cards to select a primary care provider (PCP).

Data sources/study setting: Primary data collected from 304 adult consumers living in Los Angeles County in January and February 2003.

Study design/data collection: We constructed computerized report cards for seven pairs of hypothetical individual PCPs (two internal validity check pairs included). Participants selected the physician that they preferred. A questionnaire collected demographic information and assessed participant attitudes towards different sources of report card information. The relationship between patient characteristics and number of times the participant selected the physician who excelled in technical quality are estimated using an ordered logit model.

Principal findings: Ninety percent of the sample selected the dominant physician for both validity checks, indicating a level of attention to task comparable with prior studies. When presented with pairs of physicians who varied in technical and interpersonal quality, two-thirds of the sample (95 percent CI: 62, 72 percent) chose the physician who was higher in technical quality at least three out of five times (one-sample binomial test of proportion). Age, gender, and ethnicity were not significant predictors of choosing the physician who was higher in technical quality.

Conclusions: These participants showed a strong preference for physicians of high technical quality when forced to make tradeoffs, but a substantial proportion of the sample preferred physicians of high interpersonal quality. Individual physician report cards should contain ample information in both domains to be most useful to patients.

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Figures

Figure 1
Figure 1
Example of hypothetical report with three layers of information
Figure 2
Figure 2
(A) Distribution of preferences for each of the five pairwise choices (n=304). Pair 1, HiT/AvgI (left) versus AvgT/Hi I (right); pair 2, HiT/LowI versus LowT/HiI; pair 3, AvgT/LowI versus LowT/AvgI; pair 4, AvgT/AvgI versus LowT/HiI; pair 5, HiT/LowI versus AvgT/AvgI (T, technical; I, interpersonal; Hi, high; Avg, average). (B) Distribution of preferences across five pairwise choices (n=304)
Figure 3
Figure 3
Mean values for questions assessing attitude to different aspects of care (n=304)
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References

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