Who in Brazil has a personal doctor?

Abstract

Continued medical care (including having a personal doctor) is regarded as an essential aspect of a good health service. The objectives of the present study were to investigate the reasons for not having a personal doctor, and the satisfaction with the care received by patients with and without a personal doctor. We conducted a cross-sectional study with data collected during 20 days over 6 months in the Emergency Service of the Conceição Hospital, the busiest emergency service in Porto Alegre. The subjects were 553 patients selected through systematic random sampling. The main outcome measure was having a personal doctor. Patients who reported usually to see the same doctor and remembered their physician's name were regarded as having a personal doctor. Patients who usually use primary care service represented 23% of the sample, and were four times more likely to have a personal doctor (OR = 3.83, CI 95% = 2.41-6.11). Independent, statistically significant variables associated with having a personal physician were: usually receiving care from a primary health care service (OR = 3.8, CI 95% = 2.39-6.00) and from a physician in the private sector (OR = 2.16, CI 95% = 1.15-4.00). Patients who had a personal doctor reported higher satisfaction with their access to health care. The personal doctors' specialties were: internal medicine (37%), cardiologist (17%), gynaecologist-obstetrician (13%), family physician (8%) and pneumologist (6%). For patients who attend emergency services in Brazil, primary health care and private medical care provide better access to continuity of patient care. Patients with personal doctors report higher satisfaction with access to consultations.