Provider Attitudes Impact How Far Patients With HIV Are Willing to Travel for Care


Study results indicate that patients with HIV are willing to wait at least 19 hours or travel up to 28 miles to see a “nice” provider.

A doctor’s bedside manner can have a significant impact on patient satisfaction, and now, the results of a recent study have revealed that it may also impact how far a patient is willing to travel for care. In fact, the study results indicate that patients with HIV are willing to wait at least 19 hours or travel up to 28 miles to see a “nice” provider. According to the study investigators, the implications of these results can go a long way toward helping address engaging patients with HIV and understanding what these patients want from their health services, particularly in resource-limited settings.

For the study, a total of 280 patients with HIV in Zambia who had been lost to follow-up (defined as >90 days overdue for their last scheduled appointment) were identified. After interviewing the participants, the investigators found several key considerations were common across the participants. These included: wait time at a clinic; the distance from their home to the clinic; whether or not antiretroviral therapy (ART) was provided; the hours of operation, and the attitudes of the staff.

The investigators then created 2 hypothetical clinics in which the items of consideration were variably implemented and surveyed the participants on each clinic’s attributes. Surveys were completed between December 9, 2015, and May 21, 2016.

The results of the surveys indicated that patients had strong preferences for “nice” over “rude” providers (no surprise there); however, interestingly, these patients stated that they were willing to wait 19 hours or more and travel 28 miles farther to see these nice providers (over the rude ones). Furthermore, the results of a trade-off analysis revealed that the patients were willing to travel to a clinic that was 6 miles from their home (in comparison to 3), where they would have to wait 5 hours (as opposed to 1), and they would receive 3 months of ART (as opposed to 5) just to be treated by a nice provider.

Lead study author Elvin Gene, MD, MPH, professor of medicine, University of California San Francisco, summed up the ramifications of these study results in a statement, saying, “To me, the findings further the idea that everyone wants to be treated fairly and with respect.”

The authors concluded by stating, “Differential service delivery models to reduce the logistical burden of accessing care may achieve optimal impact if combined with interventions to improve healthcare worker empathy and attitude. Interventions to optimize provider attitude have yet to figure prominently into efforts to improve global HIV treatment but should be explored.”

A version of this study coverage was originally published as, “Patients With HIV Will Forgo Short Wait Time, Travel Distance to Access Nice Providers,” on the American Journal of Managed Care website.

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