title: Physician specialty and the quality of medical care experiences in the context of the Taiwan national health insurance system.
abstract: OBJECTIVE
  Based on a recent patient survey from Taiwan, where there is universal health insurance coverage and unrestricted physician choice, this study examined the relationship between physician specialty and the quality of primary medical care experiences.
  
  
  METHODS
  We assessed ambulatory patients' experiences with medical care using the Primary Care Assessment Tool, representing 7 primary care domains: first contact (ie, accessibility and utilization); longitudinality (ie, ongoing care); coordination (ie, referrals and information systems); comprehensiveness (ie, services available and provided); family centeredness; community orientation; and cultural competence.
  
  
  RESULTS
  Having a primary care physician was significantly associated with patients reporting higher quality of primary care experiences. Specifically, relative to specialty care physicians, primary care physicians enhanced accessibility, achieved better community orientation and cultural competence, and provided more comprehensive services.
  
  
  CONCLUSIONS
  In an area with universal health insurance and unrestricted physician choice, ambulatory patients of primary care physicians rated their medical care experiences as superior to those of patients of specialists. In addition to providing health insurance coverage, promoting primary care should be included as a health policy to improve patients' quality of ambulatory medical care experiences.
authors.affiliation: Center for General Education, Hungkuang University, Shalu, Taichung County, Taiwan.
authors.forename: Jenna
authors.initials: J
authors.lastname: Tsai
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.forename: Wei-Lung
authors.initials: WL
authors.lastname: Yu
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Hung
authors.forename: Lydie A
authors.initials: LA
authors.lastname: Lebrun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000191:economics / Q000592:standards; D003430:Cross-Sectional Studies; D054521:Cultural Competency; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards*; D008875:Middle Aged; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013624:Taiwan; D019472:Universal Health Insurance / Q000592:standards*; D055815:Young Adult