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Perceptions of Quality of Care and the Decision to Leave a Practice

Division of General Internal Medicine, Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut

Thomas L. Delbanco, M.D.

Division of General Internal Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Russell S. Phillips, M.D.

Division of General Internal Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Little is known about how patients' perceptions of quality of care influence behavioral outcomes such as decisions to change the source of their care. We surveyed patients suspected of leaving a primary care internal medicine practice at an urban teaching hospital to examine their reasons for leaving, and to investigate whether decisions to leave were related to perceived quality of care. Of 185 respondents, 27 (15%) had left to follow their doctor to another practice. The other 98 (53%) patients who had left the practice cited reasons such as a change of insurance (51), physician care (31), practice operation (27), parking and transportation (24), physician departure (19), and geographic moves (17). Responses to global assessment items and a physician care rating scale were more closely associated with the decision to leave than were ratings of other specific aspects of care.

American Journal of Medical Quality, Vol. 13, No. 4, 181-187 (1998)
DOI: 10.1177/106286069801300403


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