FACTORS ASSOCIATED WITH THE PERSON-CENTERED CLINICAL METHOD IN PRIMARY HEALTH CARE: A STUDY IN PORTO ALEGRE, BRAZIL

Abstract

Background. The medical approach is influenced by several factors present at the patient, doctor, health service, society, and culture levels. Purpose. The purpose of this paper is to establish the degree of person-centeredness of care attributed by patients to the clinical approach of physicians from a primary health care (PHC) service and to ascertain its association with variables related to the care recipient. Methods. This cross-sectional study was conducted with a sample of patients (n = 408) with hypertension and/or diabetes treated at 12 health centers belonging to a PHC network in the city of Porto Alegre, Rio Grande do Sul, Brazil. The degree of person-centered clinical method (PCCM) orientation was measured by the “Patient Perception of Patient-Centeredness” (PPPC) questionnaire. Results. The variables “educational attainment” and “duration of follow-up with the same physician” were significantly associated with a higher prevalence of low overall PPPC scores (corresponding to higher patient centeredness) assigned to physicians by the patients (PR = 1.04, 95% CI = 1.02–1.06, p-value < 0.001 and PR = 1.01, 95% CI = 1.00–1.02, p-value = 0.032, respectively). On the other hand, the variables “living alone” and “fair/poor/very poor self-perception of health” were significantly associated with a lower prevalence of person centeredness (PR = 0.83, 95% CI = 0.72–0.96, p-value = 0.011 and PR = 0.88, 95% CI = 0.77–1.00, p-value = 0.041, respectively). Conclusions. These findings demonstrate that clinical approaches to people with a high level of social vulnerability require improvement, and that the length of follow-up provided by one physician can be an indicator of the extent to which providers are able to deliver person-centered care.