Continuity of care and trust in one's physician: evidence from primary care in the United States and the United Kingdom.

BACKGROUND AND OBJECTIVES

Patients' trust in their physician to act in their best interest contributes to the effectiveness of medical care and may be related to the structure of the health care system. This study explored the relationship between continuity of care and trust in one's physician, particularly in terms of differences between the United States and the United Kingdom (UK).

METHODS

We conducted a cross-sectional survey of adult patients (n = 418 in the United States and n = 650 in the UK) who presented in outpatient primary care settings in the United States (Charleston, SC, and Lexington, Ky) and in the UK (Leicester and Exeter).

RESULTS

A high percentage of both groups of patients reported having a usual place of care and doctor. A total of 69.8% of UK patients and 8.0% of US patients have had their regular physician for > or = 6 years. US patients (92.4%) are more likely than UK patients (70.8%) to value continuity with a doctor. Both groups had high levels of trust in their regular doctor. Trust was related to one continuity measure (length of time for the relationship) but not to another (usual provider continuity index more than 1 year). 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.