Leiyu Shi1, Lydie A Lebrun-Harris, Sarika Rane Parasuraman, Jinsheng Zhu, Quyen Ngo-Metzger. 1. the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins Primary Care Policy Center, Baltimore, MD; the Office of Quality and Data, Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD.
Abstract
BACKGROUND: We investigated the quality of the primary care experienced by health center (HC) patients and investigated whether race/ethnicity and insurance coverage were significantly associated with patients' experiences. METHODS: Cross-sectional data came from the 2009 Health Center Patient Survey. Outcomes included 10 measures of patients' experiences with primary care domains, including: (1) accessibility, (2) communication, (3) comprehensiveness, and (4) coordination of care. RESULTS: Patients who received care at HCs reported high-quality primary care, particularly regarding accessibility and communication. For example, more than 94% of patients reported that their HC location was convenient, and more than 94% reported that their provider adequately explained what they wanted to know. After adjusting for sociodemographic characteristics, few significant racial/ethnic and insurance-related disparities were observed. In the domains of comprehensiveness and coordination, insured patients generally had better experiences than uninsured patients. For instance, Medicaid-insured patients had higher odds of reporting that HC staff helped them arrange medical appointments at other health care settings than uninsured patients (odds ratio, 2.04; 95% confidence interval, 1.35-3.09). CONCLUSIONS: As safety-net providers for vulnerable populations, HCs provide high-quality primary care and do not exhibit the extent of disparities that exist in other US health care settings. Continued efforts are necessary to address insurance-related disparities, particularly among uninsured patients.
BACKGROUND: We investigated the quality of the primary care experienced by health center (HC) patients and investigated whether race/ethnicity and insurance coverage were significantly associated with patients' experiences. METHODS: Cross-sectional data came from the 2009 Health Center Patient Survey. Outcomes included 10 measures of patients' experiences with primary care domains, including: (1) accessibility, (2) communication, (3) comprehensiveness, and (4) coordination of care. RESULTS:Patients who received care at HCs reported high-quality primary care, particularly regarding accessibility and communication. For example, more than 94% of patients reported that their HC location was convenient, and more than 94% reported that their provider adequately explained what they wanted to know. After adjusting for sociodemographic characteristics, few significant racial/ethnic and insurance-related disparities were observed. In the domains of comprehensiveness and coordination, insured patients generally had better experiences than uninsured patients. For instance, Medicaid-insured patients had higher odds of reporting that HC staff helped them arrange medical appointments at other health care settings than uninsured patients (odds ratio, 2.04; 95% confidence interval, 1.35-3.09). CONCLUSIONS: As safety-net providers for vulnerable populations, HCs provide high-quality primary care and do not exhibit the extent of disparities that exist in other US health care settings. Continued efforts are necessary to address insurance-related disparities, particularly among uninsured patients.
Entities:
Keywords:
Ethnicity; Health Care Disparities; Health Insurance; Quality of Health Care; Race