The relationship between multimorbidity and patients' ratings of communication.

Journal of General Internal Medicine
Constance H FungElizabeth A McGlynn

Abstract

The growing interest in pay-for-performance and other quality improvement programs has generated concerns about potential performance measurement penalties for providers who care for more complex patients, such as patients with more chronic conditions. Few data are available on how multimorbidity affects common performance metrics. To examine the relationship between multimorbidity and patients' ratings of communication, a common performance metric. Cross-sectional study Nationally representative sample of U.S. residents A total of 15,709 noninstitutionalized adults living in the United States participated in a telephone interview. We used 2 different measures of multimorbidity: 1) "individual conditions" approach disregards similarities/concordance among chronic conditions and 2) "condition-groups" approach considers similarities/concordance among conditions. We used a composite measure of patients' ratings of patient-physician communication. A higher number of individual conditions is associated with lower ratings of communication, although the magnitude of the relationship is small (adjusted average communication scores: 0 conditions, 12.20; 1-2 conditions, 12.06; 3+ conditions, 11.90; scale range 5 = worst, 15 = best). This...Continue Reading

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