Patient Experiences with Coordination of Care

The Benefit of Continuity and Primary Care Physician as Referral Source

Coordination of care between referring physicians and specialists is highly valued by patients, and is generally associated with higher quality care. This cross-sectional study examines the extent to which adults report that continuity of care and referral source are associated with better coordination of care. Data were taken from the 2007 Health Tracking Household Survey, and information from 3,436 adults was analyzed for the study.

The study relied on three measurements: patient perceptions of how informed and up-to-date the primary care physician (PCP) was about specialist care received; whether the PCP talked with the patient about what happened at the recent specialist visit; and how well different doctors caring for a patient’s chronic condition worked together.

Key findings:

  • The percent of patients (46%) reported that their PCP ‘always seemed informed about specialist care received.’
  • Patients who usually see the same PCP (62%) reported that their PCP discussed their specialist visit with them, versus 48 percent of patients who do not usually see the same PCP.
  • When a patient’s recent specialist visit was based on PCP referral, 50 percent reported that the PCP was informed and up-to-date about specialist care received, versus 35 percent for self- or other referral.
  • People over 65 years were more likely to rate their coordination highly. There were no differences in coordination ratings by income, race and ethnicity, or primary language.

The authors conclude that the majority of respondents reported less than ideal coordination of care. Continuity of care with the same PCP, and with the PCP as referral source, were both associated with higher coordination ratings. Implications for improving patient satisfaction and quality of care are that continuity of care with one PCP is very important, and that patients should be engaged in dialogue about the importance of having their PCP refer them to specialists.