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July 14, 2008

Older Patients More Satisfied with Care When Accompanied to Medical Visits

Medical Visit Companions Could Be Resource for Vulnerable Older Adults

A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that 38 percent of Medicare beneficiaries are accompanied to routine medical visits. These accompanied beneficiaries tended to be older, sicker and less educated but more satisfied with their health care provider compared to unaccompanied patients. The study is published in the July 14 edition of Archives of Internal Medicine.

“We found that patients were more satisfied with their care when visit companions were actively involved in the communication between patient and provider,” saidJennifer L. Wolff, PhD, assistant professor in the Bloomberg School’s Department of Health Policy and Management. “Our findings suggest that visit companions could be an important resource for vulnerable older adults—a population that tends to have more chronic conditions and utilizes more health care services.”

Data for the study was gathered from the nationwide 2004 Medicare Current Beneficiary Survey, which for the first time included information on beneficiaries’ visit companions. The study included 12,018 Medicare beneficiaries 65 and older living in the community.

According to the study, visit companions were most often a spouse (53.9 percent) or adult child (31.9 percent). Less than 1 percent of beneficiaries were accompanied by a nurse, nurse’s aid or other professional. More than 60 percent of visit companions participated in the communication process by recording the physician’s instructions (44.1 percent), providing information about the patient’s medical needs (41.6 percent), asking questions (41.1 percent), or explaining the physician’s instructions (29.7 percent). The researchers found that accompanied beneficiaries whose visit companion was more actively engaged in communication rated their physician’s information-giving and interpersonal skills more favorably than did unaccompanied beneficiaries. This relationship was strongest among beneficiaries who reported having the worst health.

“For physicians, these findings highlight the potential value of visit companions to assist them in meeting the informational and interpersonal needs of their most vulnerable older patients,” said Debra L. Roter, DrPH, MPH, professor in the Bloomberg School’s Department of Health, Behavior and Society.

“Hidden in Plain Sight” was written by Jennifer L. Wolff, PhD, and Debra L. Roter, DrPH, MPH.

The research was supported by the Johns Hopkins Bloomberg School of Public Health.

Public Affairs media contact for the Johns Hopkins Bloomberg School of Public Health: Tim Parsons at 410-955-6878 or tmparson@jhsph.edu.