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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Debra Roter, DrPH1, Marla L. Clayman, MPH1, Susan Larson, MS1, and Mary Ann Cook, BSN, MA, PhD2. (1) Health Policy and Management, Johns Hopkins University, 624 North Broadway, Room 750, Baltimore, MD 21205, (2) JVC Radiology and Medical Analysis LLC, 6319 Alexander Drive, Clayton, MO 63105
Objective: To determine the differences between accompanied and unaccompanied geriatric primary care visits.
Background: Although companions are relatively common among geriatric primary care visits, few studies have compared dyadic to triadic visits.
Design/Methods: Videotapes of a cross-sectional sample (n=406) of non-cognitively-impaired geriatric patients with study physicians (n=36) were coded using the Roter Interaction Analysis System (RIAS). Regression analyses were conducted using clustering techniques (GEE) to account for the effect of multiple visits with the same physician.
Results: Ninety visits (22%) with 29 physicians (81%) included a companion. The average visit length of unaccompanied and accompanied patients was 16.5 and 19.4 minutes, respectively (p<.05). Accompanied patients were older and reported poorer health status than unaccompanied patients (p<.05). Unaccompanied patients did not differ those with companions by gender or marital status, although there were differences by race and ethinicity. After accounting for physician clustering, accompanied patients asked significantly fewer questions (p<.01) and gave less biomedical (p<.01) and psychosocial (p<.01) information than unaccompanied patients.
Physicians in this sample are predominantly internists (n=22, 59%), followed by family physicians (n=10, 27%), and subspecialists (n=5, 14%). The average age of patients among physicians with and without companions did not differ; however, almost one-third of internists (n=7) saw only unaccompanied patients, while all non-internal medicine physicians saw patients of both groups.
Conclusions: Geriatric visits with companions are longer and have older patients than those without companions. The presence of a companion has consequences for patient information-giving and question-asking, although it does not affect physician talk.
Learning Objectives: At the end of the session, the participant will be able to
Keywords: Elderly, Communication
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.