For the study, researchers analyzed data from more than 70,000 U.S. adults who took part in a Medical Expenditure Panel Survey. Of those, more than 49,000 had a primary care doctor and about 21,000 did not.
Adults with primary care were more likely to receive high-value cancer screenings, such as colonoscopy or mammography (78 percent with primary care versus 67 percent without). They also received more diagnostic and preventive tests, such as flu vaccination and blood pressure checks.
Patients with primary care were also more likely to receive counseling, especially to help them quit smoking, the investigators found.
“If you have a primary care relationship, you have a better experience with care, better access to care, and a 10 percent increase in things like high-value cancer screening, diabetes care and counseling,” said the study’s corresponding author, Dr. David Levine. He’s a physician investigator in the division of general internal medicine and primary care at Brigham and Women’s Hospital, in Boston.
The study findings suggest that a primary care-first approach could improve U.S. health care, Levine said in a hospital news release.
However, the researchers also found that both groups of patients had similar rates of low-value care. For example, inappropriate antibiotic use was 11 percent more common among primary care patients than those without primary care.
Still, 79 percent of patients with primary care rated their health care as excellent versus 69 percent of others, according to the report published online Jan. 28 in the journal JAMA Internal Medicine.
“Patients who don’t have this continuous relationship, and instead have fractionated care, lose out on high-value care and a better care experience,” Levine explained.
The study did find an association between primary care and worse care for heart failure and lung disease. The researchers suggested that the link may owe to the relatively small number of adults without primary care who had these diseases, and the fact that many of these patients were co-managed by specialists.
“We’ve seen a trend in people opting for less primary care suggesting that the American health care system doesn’t place much value on primary care,” Levine said.
“However, our study finds that the primary care relationship can lead to better quality care and a better experience for patients. There’s more to health care than a one-time interaction that isn’t comprehensive. Having continuity that accounts for the whole person is much more important than anyone thought previously,” he concluded.WebMD News from HealthDay
SourcesSOURCE: Brigham and Women’s Hospital, news release, Jan. 28, 2019
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