CELLPHONE, EMAIL, AND TEXT-MESSAGING AND PATIENT-PHYSICIAN COMMUNICATION IN PRIMARY CARE

primary care;patient-provider communication;health technology;not listed

Lee, Joy Li-YuehGallo, Joseph J ;

Johns Hopkins University

关键词: primary care;    patient-provider communication;    health technology;    not listed;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60546/LEE-DISSERTATION-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Patient-provider communication is an important aspect of quality of care and poor communication is a frequent problem. Evolving communication technologies can create new problems as well as offer opportunities for addressing them.It is not known how providers choose among available technologies, decide who of their patients to communicate using such technology, or how use influences patient satisfaction.This thesis addresses these questions in three aims, incorporating a survey of primary care providers on their communication patterns, the linkage of survey results with existing patient-reported data, and qualitative interviews with primary care physicians on their experiences with favorite patients.In Aim 1, I found that while more providers had used their cellphones than email to communicate to patients (54% vs. 38%, p=0.03), they were more inclined to give their email addresses than cellphone numbers (56% vs. 37%, p<0.001).Academic providers and providers who gave patients their email addresses were more likely to communicate with their patients electronically than community providers and those who did not give email addresses, respectively.In Aim 2, multivariable regression analyses revealed that making email addresses available to patients by non-pediatric providers was associated with a 19-point difference in overall satisfaction but not individual satisfaction domains.The offering of a provider email address is a signifier of a strong patient-provider relationship. The use of cellphone, email, and text-messaging was not associated with satisfaction.In Aim 3, I found that favorite patients are often not like their physicians in socio-demographic and personality characteristics.Cellphone numbers were privileged by physicians and when given, only to a few patients whose illnesses warranted having direct access; email addresses were given more often, especially when the patient was a fellow physician or employee of the same medical institution.Some favorite patients fell into these categories; others did not.These findings suggest the need for institutional guidelines that establish expectations and boundaries in communicating with patients outside of the office.