Trends in the perceived complexity of primary health care: A secondary analysis

David A Katerndahl, Michael Parchman, Robert Wood

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Rationale If the complexity of the patient's medical problems increases or the complexity of the interactions between the doctor and the patient, the staff or the health care system increase, then complexity of patient care will increase. This study examined trends in patient complexity, and identified doctor, practice and improvement strategy characteristics associated with perceived complexity. Methods This secondary analysis used data from three Community Tracking Surveys with 22 134 primary care doctors completing surveys about themselves, their practice setting, practice improvement strategies and complexity of care in three consecutive 2-year time periods (1996-1997, 1998-1999, 2000-2001). Data were analysed using hierarchical logistic regression. Results The proportion of primary care doctors who perceived that complexity of care had increased over the past 2 years rose from 31.5% to 35.9%. Perceived complexity of patient care was consistently related to being in solo practice and the belief that they could not frequently obtain high-quality services and referrals for patients. As availability of services increased, complexity decreased whereas as use of practice improvement strategies increased, complexity also increased. Conclusions Understanding that we cannot determine whether respondents understood care as 'complicated' or 'complex', potential consequences of this increase in complexity include an increase in medical errors and referral rates along with decreased quality of patient care and career satisfaction.

Original languageEnglish (US)
Pages (from-to)1002-1008
Number of pages7
JournalJournal of Evaluation in Clinical Practice
Volume16
Issue number5
DOIs
StatePublished - Oct 2010

Fingerprint

Primary Health Care
Patient Care
Referral and Consultation
Medical Errors
Quality of Health Care
Private Practice
Logistic Models
Delivery of Health Care
Surveys and Questionnaires

Keywords

  • ambulatory care
  • delivery of health care
  • health service
  • non-linear dynamics
  • primary health care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

Cite this

Trends in the perceived complexity of primary health care : A secondary analysis. / Katerndahl, David A; Parchman, Michael; Wood, Robert.

In: Journal of Evaluation in Clinical Practice, Vol. 16, No. 5, 10.2010, p. 1002-1008.

Research output: Contribution to journalArticle

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