Comprehending care in a medical home: a usual source of care and patient perceptions about healthcare communication.

Comprehending care in a medical home: a usual source of care and patient perceptions about healthcare communication.
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DOI:
10.3122/jabfm.2008.05.080054
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发表时间:
2008-09
期刊:
Journal of the American Board of Family Medicine : JABFM
影响因子:
--
通讯作者:
Fryer GE Jr
Fryer GE Jr
中科院分区:
其他
文献类型:
--
作者:
DeVoe JE;Wallace LS;Pandhi N;Solotaroff R;Fryer GE Jr

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The recent emphasis on improving health literacy highlights the importance of building strong relationships between patients and healthcare providers. Patients perceiving good communication in healthcare settings report better health status. Having a usual source of care (USC) may play a key role in achieving optimal communication between patients and physicians. To determine if having an identified place for usual care is more often associated with positive patient perceptions about their communication and relationships with healthcare providers. Cross-sectional descriptive and multivariable analysis of the 2002 Medical Expenditure Panel Survey (MEPS), a nationally representative survey. Civilian non-institutionalized US population aged ≥18 years who had visited a healthcare provider in the 12 months prior to the survey (N=approximately 16,700). Respondents perceptions of their physicians’ communication skills, measured in six related survey questions. Responses along a four-point Likert scale were dichotomized into “always” and “not always.” Approximately 78% of U.S. adults reported having a USC in 2002. Among those who visited a healthcare provider in the 12 months prior to the 2002 MEPS survey, positive patient perceptions about physician communication were significantly associated with having an identified USC. When compared with adults reporting no USC (reference group, OR=1.0), adults with a USC were more likely to report that their providers always listened to them (OR=1.31, 95% CI 1.16-1.48), always explained things so they can understand (OR=1.26, 95% CI 1.13-1.41), always showed respect (OR=1.24, 95% CI 1.10-1.40), and always spent enough time with them (OR=1.20, 95% CI 1.07-1.35). Among those with an identified USC, several demographic factors were associated with patient perceptions of autonomy in making healthcare decisions, including: non-Hispanic ethnicity, private health insurance coverage, having a rural residence, living in a Western census region, and having a higher income. Patients who have a usual place to go for healthcare needs are more likely to report positive communication and interactions with their healthcare providers. This study suggests that one way to improve communication in healthcare settings is to develop policies and practices to ensure that all patients have consistent access to a usual source of care.
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