Continuity of Care and Trust in One's Physician: A Comparison of the United States and the United Kingdom

Journal of Family Practice, March, 2001 by Arch G. Iii Mainous, Richard Baker, Margaret M. Love, James M. Gill, Edsel Baker

A Comparison of the United States and the United Kingdom

* BACKGROUND Our objective was to explore the relationship between continuity of care and trust in one's physician, particularly in terms of the differences between the United States and the United Kingdom.

* METHODS This was a cross-sectional survey of 803 adult patients in outpatient primary care practices (n=418 in US family practices; n=385 in United Kingdom general practices). The main outcome was trust in one's physician measured by the Trust in Physician Scale.

* RESULTS Although UK patients (98.1%) were more likely than US patients (88.2%) to report having a usual site of care (P=.0001), there was no difference between the UK patients (81.6%) and the US patients (79.0%) in likelihood of having a regular physician (P=.36). A total of 53.0% of the UK patients and 8.0% of the US patients have had their regular physicians for more than 6 years (P=.0001). US patients (83.9%) are more likely than UK patients (60.4%) to value continuity with a physician (P=.0001). The US patients (mean=44.9) have a slightly higher level of trust in their physicians than the UK patients (mean=43.8; P=.02), although both groups have high levels of trust. In a multivariate model country of residence had no independent relationship with trust, but continuity of care was significantly related.

* CONCLUSIONS Higher continuity is associated with a higher level of trust between a patient and a physician. Efforts to improve the relationship between patients and physicians may improve the quality and outcomes of care.