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Incidence and contributing factors to termination of the patient-physician relationship

PURPOSE: Identify the incidence and factors contributing to the termination of gynecologic patient-physician relationships. METHODS: All patients terminated from the practice between January 2008 and December 2012 were identified. Charts were reviewed for demographic information, termination reason,...

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Autores principales: Santoso, Joseph T., Yibirin, Edmundo, Crigger, Mary, Wan, Jim, ElNaggar, Adam C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909815/
https://www.ncbi.nlm.nih.gov/pubmed/27355000
http://dx.doi.org/10.1016/j.gore.2016.05.011
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author Santoso, Joseph T.
Yibirin, Edmundo
Crigger, Mary
Wan, Jim
ElNaggar, Adam C.
author_facet Santoso, Joseph T.
Yibirin, Edmundo
Crigger, Mary
Wan, Jim
ElNaggar, Adam C.
author_sort Santoso, Joseph T.
collection PubMed
description PURPOSE: Identify the incidence and factors contributing to the termination of gynecologic patient-physician relationships. METHODS: All patients terminated from the practice between January 2008 and December 2012 were identified. Charts were reviewed for demographic information, termination reason, and cancer diagnosis. RESULTS: In the five year study period, 8851 new patients presented to the division of gynecologic oncology. Within this cohort, 123 patient-physician relationships were terminated. Among terminated patients, missed appointments (63.4%), noncompliance to treatment (23.6%), disruptive behavior (10.6%), and drug abuse behavior (2.4%) were the key reasons for termination. While no patients were terminated for financial reason, statistical differences were found for those with Medicaid insurance (OR = 5; 95% CI: 3.4–7.1). Terminated patients were more likely to be younger, African American/Black, and have a diagnosis of GTD or cancer, particularly cervical cancer, when compared against all retained patients. CONCLUSION: The prevalence of patient-physician relationship termination was low at 1.4% (123/8851). However, the finding that the 52% of terminated patients had a diagnosis of cancer is concerning; 73% of which had stage III or greater disease, or were unstaged. We hope that the identification and quantification of reasons for termination and those at risk for termination, as well as the introduction of patient-navigators, will lead to improved methods to ensure patient compliance and retention.
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spelling pubmed-49098152016-06-28 Incidence and contributing factors to termination of the patient-physician relationship Santoso, Joseph T. Yibirin, Edmundo Crigger, Mary Wan, Jim ElNaggar, Adam C. Gynecol Oncol Rep Case Series PURPOSE: Identify the incidence and factors contributing to the termination of gynecologic patient-physician relationships. METHODS: All patients terminated from the practice between January 2008 and December 2012 were identified. Charts were reviewed for demographic information, termination reason, and cancer diagnosis. RESULTS: In the five year study period, 8851 new patients presented to the division of gynecologic oncology. Within this cohort, 123 patient-physician relationships were terminated. Among terminated patients, missed appointments (63.4%), noncompliance to treatment (23.6%), disruptive behavior (10.6%), and drug abuse behavior (2.4%) were the key reasons for termination. While no patients were terminated for financial reason, statistical differences were found for those with Medicaid insurance (OR = 5; 95% CI: 3.4–7.1). Terminated patients were more likely to be younger, African American/Black, and have a diagnosis of GTD or cancer, particularly cervical cancer, when compared against all retained patients. CONCLUSION: The prevalence of patient-physician relationship termination was low at 1.4% (123/8851). However, the finding that the 52% of terminated patients had a diagnosis of cancer is concerning; 73% of which had stage III or greater disease, or were unstaged. We hope that the identification and quantification of reasons for termination and those at risk for termination, as well as the introduction of patient-navigators, will lead to improved methods to ensure patient compliance and retention. Elsevier 2016-05-31 /pmc/articles/PMC4909815/ /pubmed/27355000 http://dx.doi.org/10.1016/j.gore.2016.05.011 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Series
Santoso, Joseph T.
Yibirin, Edmundo
Crigger, Mary
Wan, Jim
ElNaggar, Adam C.
Incidence and contributing factors to termination of the patient-physician relationship
title Incidence and contributing factors to termination of the patient-physician relationship
title_full Incidence and contributing factors to termination of the patient-physician relationship
title_fullStr Incidence and contributing factors to termination of the patient-physician relationship
title_full_unstemmed Incidence and contributing factors to termination of the patient-physician relationship
title_short Incidence and contributing factors to termination of the patient-physician relationship
title_sort incidence and contributing factors to termination of the patient-physician relationship
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909815/
https://www.ncbi.nlm.nih.gov/pubmed/27355000
http://dx.doi.org/10.1016/j.gore.2016.05.011
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