The Effects of Organization Design and Patient Perceptions of Care on Switching Behavior and Reliance on a Health Care System Across Time. (April 2016)

• Record Type: Journal Article
• Authors: Labonte, Alan J.; Benzer, Justin K.; Burgess, James F.; Cramer, Irene E.; Meterko, Mark; Pogoda, Terri K.; Charns, Martin P.
• Is Part Of: Medical care research and review. Volume 73:Number 2(2016:Apr.)
• Page Start: 182
• Page End: 204
• Publication Date: 2016-04
• Subjects: service quality -- reliance -- health care system -- switching behavior -- organization design; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/1077558715601543
• Languages: English
• ISSNs: 1077-5587

Abstract

Sustaining ongoing relationships with patients is a strategic, clinically relevant goal of health care systems. This study develops and tests a conceptual model that aims to account for the influence of organization design, perceptions of quality of patient care, and other patient-level factors on the extent to which patients sustain reliance on a health care system. We use a longitudinal survey design and structural equation modeling to predict increases or decreases in patient reliance on the Department of Veterans Affairs health care system across a 4-year period for Veterans with Parkinson's Disease. Our findings show that specialized and integrated clinical practices have a positive association with the quality of patient care. Health care systems may be able to foster long-term relations with patients and improve service quality by allocating resources to form integrated, specialized, disease-specific centers of care designed for patients with chronic illnesses.