Provider/Patient Relationships and Quality of Care

One approach to improving health care and health outcomes is to change the traditional doctor/patient relationship to one in which the patient gets more information and more input into decisions make regarding their health care and doctors are solicitous of that input.  The Health Foundation did a review of the evidence for whether various interventions designed to change the care relationship improved quality.   (Health Foundation Report)   Among the specific interventions tested were patient self-administration of medication, patient access to online health records, specific mechanisms to address complaints, use of peer support workers, and involving certain patients in shared decision-making.  Care quality measures included effectiveness, safety, person-centeredness, timeliness, efficiency and equity.  There was a fairly robust level of evidence of effectiveness for some of the interventions.  Findings on person-centeredness were more mixed.  The other types of measures were less frequently studied, but there was some evidence for cost-savings, as a reflection of efficiency. In terms of a causative explanation for how changing the care relationship may improve, or worsen, quality of care, the research is not particularly explicit, but the review authors hypothesize that it is due to patients feeling more knowledgeable and therefore more confident in their abilities to manage their health.