# PHYSICIAN-PATIENT RELATIONSHIPS--OUTCOMES FOR THE ELDERL

> **NIH NIH R01** · TUFTS MEDICAL CENTER · 1988 · $240,900

## Abstract

The health care delivery system is being restructured with the
immediate goal of containing costs.  Thus, the success of
competing systems is typically equated with how well they achieve
this goal.  But in the long run, changes in the organization and
financing of care for the elderly must strike a balance between
containing costs and preserving the features of medical care
process essential to producing good outcomes.  This situation is
particularly crucial for the elderly, who are being encouraged to
enroll in health maintenance organizations and competitive
medical plans to control rising costs under the Medicare program.
To control costs without harm to health, policymakers must be
better informed about the effects of cost containment of the
style of medical care practiced and the implications for patient
outcomes.

We propose to analyze data from the Medical Outcomes Study
(MOS), an ongoing investigation that provides a unique opportunity
to address these issues.  The MOS is a major 6-year study of
patients with prevalent and treatable chronic conditions
(hypertension, diabetes, heart disease and depression) sampled to
represent solo and group practices and both prepaid and fee-for-
service arrangements in Boston, Chicago, and Los Angeles.  The
MOS database is characterized by:  breadth and depth of outcome
measures and case-mix variables, repeated measurements over a
2-year period, and large cross-sectional (N-22,785) and
longitudinal (N-2,546) samples.  Of the longitudinal sample, 37%
are 65 and older.

The proposed research would extend MOS analyses, without
additional data collection, to determine differences between
health care delivery systems in physician style of caring for
elderly and middle-aged patients, the characteristics of elderly
patients and their physicians that account for variations in
practice styles, and the implications for patient outcomes.
Practice style is defined in terms of the quality of interpersonal
aspects of the doctor-patient relationship, the extent of patient
involvement in decision-making and information exchange, and
the presence of counseling for mental health problems and
personal health practices.  Three health outcomes (clinical status,
functioning in everyday activities, and general well-being) and
patient satisfaction will be studied.

## Key facts

- **NIH application ID:** 3120001
- **Project number:** 1R01AG008409-01
- **Recipient organization:** TUFTS MEDICAL CENTER
- **SAM.gov UEI:** MY2ERHGDV956
- **Principal Investigator:** JOHN E WARE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1988
- **Award amount:** $240,900
- **Award type:** 1
- **Project period:** 1988-09-01 → 1990-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3120001

## Citation

> US National Institutes of Health, RePORTER application 3120001, PHYSICIAN-PATIENT RELATIONSHIPS--OUTCOMES FOR THE ELDERL (1R01AG008409-01). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3120001. Licensed CC0.

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