Trust in the referring physician reduces anxiety in an integrated community-to-hospital care system

Isr J Health Policy Res. 2020 May 11;9(1):7. doi: 10.1186/s13584-020-00365-6.

Abstract

Background: Continuity of care between the community and hospital is considered of prime importance for quality of care and patient satisfaction, and for trust in the medical system. In a unique model of continuity of care, cardiologists at our hospital serve as primary, community-based cardiologists one day a week. They refer patients from the community to our hospital for interventional procedures such as coronary angiography and angioplasty. We examined the hypotheses that patient anxiety during hospital-based coronary angiography is lower when a patient trusts the referring cardiologist and when the performing cardiologist also treated him/her in the community.

Methods: We administered questionnaires to 64 patients in our cardiology department within 90 min of completion of coronary angiography. The questions assessed anxiety, trust in the medical system and trust in the referring physician. Data were also collected regarding patients' demographic variables, the number of visits to the referring physician, and whether the physician who performed the coronary angiography was the physician who referred the patient to the hospital.

Results: Mean levels (on 7-point Likert scales) were 2.1, 5.6 and 6.7 for patient anxiety, trust in the medical system and trust in the referring physician, respectively. Multivariate regression analysis showed that trust in the referring physician was significantly and negatively correlated with anxiety level. The number of visits to referring physicians, patients' demographic characteristics and whether the physician who performed the angiography was the same physician who referred the patient from the community were not found to be associated with patient anxiety.

Conclusion: In this study, trusting the referring physician was associated with lower anxiety among patients who underwent coronary angiography. This trust seemed to have more positive impact than did previous contact with the physician who performed the procedure.

Keywords: Anxiety; Continuity of care; Hospitalization; Trust.

MeSH terms

  • Aged
  • Anxiety / prevention & control*
  • Anxiety / psychology
  • Community Health Centers / organization & administration
  • Community Health Centers / statistics & numerical data
  • Delivery of Health Care, Integrated / organization & administration
  • Delivery of Health Care, Integrated / standards*
  • Delivery of Health Care, Integrated / statistics & numerical data
  • Female
  • Hospitals / standards
  • Hospitals / statistics & numerical data
  • Humans
  • Israel
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Physician-Patient Relations*
  • Referral and Consultation / standards
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires
  • Trust / psychology*