Process Matters in Primary Care Delivery to Vulnerable Patients

August 07, 2015 02:54 pm Sheri Porter – New research published in the July/August 2015 issue of Annals of Family Medicine suggests that low-income patients with multiple health issues -- and staff members at primary care clinics where those patients receive care -- have something in common. 

Namely, neither group is entirely satisfied with the process of clinical encounters, beginning with the patient's first phone call to make an appointment.

Authors of the article(, titled "Exploring the Patient and Staff Experience With the Process of Primary Care," noted that patient experience, as a measure of patient centeredness, "has become increasingly important in assessments of primary care quality."

However, patient-experience surveys have been offered almost exclusively to Medicare and privately insured patients, "leaving the voices of patients in the lowest socioeconomic status underrepresented," said the authors.

Researchers sought to correct that omission by conducting patient and staff interviews in three primary care clinics in Philadelphia using "open-ended" interview guides that encouraged study participants to "speak freely and in their own words about each step of the primary care process."

Between August 2012 and March 2013, interviewers spoke with 21 patients with chronic illnesses who were either uninsured or Medicaid beneficiaries. Interviews also were conducted with 30 clinic staff members -- including physicians, nurses, practice managers and front desk personnel -- who worked at either the one federally qualified health center or one of two academically affiliated clinics included in the study.

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