title: Attributes of patient-centered primary care associated with the public perception of good healthcare quality in Brazil, Colombia, Mexico and El Salvador.
abstract: This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries.
authors.affiliation: Takemi Program in International Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA, Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Mexico City 06720, Mexico.
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Doubova
authors.affiliation: Division of Social Protection and Health, Inter-American Development Bank, Dean Valdivia 148-Piso 10, Centro Empresarial Platinum Plaza, San Isidro Lima 27, Peru.
authors.forename: Frederico C
authors.initials: FC
authors.lastname: Guanais
authors.affiliation: Division of Social Protection and Health, Inter-American Development Bank, Reforma 222 Piso 11, Mexico City 06726, Mexico, rperez@iadb.org.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez-Cuevas
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: David
authors.initials: D
authors.lastname: Canning
authors.affiliation: Departments of Health Policy and Management and Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South, Center for Health Sciences, Los Angeles, CA 90095-1772, USA and.
authors.forename: James
authors.initials: J
authors.lastname: Macinko
authors.affiliation: Takemi Program in International Health, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Reich
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007843:Latin America; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011787:Quality of Health Care
keywords: Healthcare quality; Latin American countries; patient-centered care; primary care; public perception