title: Influence of shared medical appointments on patient satisfaction: a retrospective 3-year study.
abstract: OBJECTIVE
  Shared medical appointments (SMAs) are becoming popular, but little is known about their association with patient experience in primary care. We performed an exploratory analysis examining overall satisfaction and patient-centered care experiences across key domains of the patient-centered medical home among patients attending SMAs vs usual care appointments.
  
  
  METHODS
  We undertook a cross-sectional study using a mailed questionnaire measuring levels of patient satisfaction and other indicators of patient-centered care among 921 SMA and 921 usual care patients between 2008 and 2010. Propensity scores adjusted for potential case mix differences between the groups. Multivariate logistic regression assessed propensity-matched patients' ratings of care. Generalized estimating equations accounted for physician-level clustering.
  
  
  RESULTS
  A total of 40% of SMA patients and 31% of usual care patients responded. In adjusted analyses, SMA patients were more likely to rate their overall satisfaction with care as "very good" when compared with usual care counterparts (odds ratio=1.26; 95% CI, 1.05-1.52). In the analysis of patient-centered medical home elements, SMA patients rated their care as more accessible and more sensitive to their needs, whereas usual care patients reported greater satisfaction with physician communication and time spent during their appointment.
  
  
  CONCLUSIONS
  Overall, SMA patients appear more satisfied with their care relative to patients receiving usual care. SMAs may also improve access to care and deliver care that patients find to be sensitive to their needs. Further research should focus on enhancing patient-clinician communication within an SMA as this model of care becomes more widely adopted.
authors.affiliation: Veterans Administration Boston Healthcare System, Jamaica Plain, Massachusetts Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts lheyworth@gmail.com.
authors.forename: Leonie
authors.initials: L
authors.lastname: Heyworth
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Ronen
authors.initials: R
authors.lastname: Rozenblum
authors.affiliation: Veterans Administration Boston Healthcare System, Jamaica Plain, Massachusetts.
authors.forename: James F
authors.initials: JF
authors.lastname: Burgess
authors.affiliation: Veterans Administration Boston Healthcare System, Jamaica Plain, Massachusetts.
authors.forename: Errol
authors.initials: E
authors.lastname: Baker
authors.affiliation: Veterans Administration Boston Healthcare System, Jamaica Plain, Massachusetts.
authors.forename: Mark
authors.initials: M
authors.lastname: Meterko
authors.affiliation: Harvard Vanguard Medical Associates, Newton, Massachusetts.
authors.forename: Debra
authors.initials: D
authors.lastname: Prescott
authors.affiliation: Carolinas Healthcare, Charlotte, North Carolina.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Neuwirth
authors.affiliation: Veterans Administration Boston Healthcare System, Jamaica Plain, Massachusetts Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: access to care; patient experience; patient satisfaction; patient-centered care; practice-based research; primary care; shared medical appointments