title: Hispanics' Satisfaction with Free Clinic Providers: An Analysis of Patient-Centered Medical Home Characteristics.
abstract: Hispanic Americans are less likely to be insured and they experience cultural and linguistic barriers that may prevent them from obtaining necessary and preventive healthcare. Adoption of Patient Centered Medical Home (PCMH) concepts in healthcare settings utilized by Hispanics could improve Hispanic patients' satisfaction with their healthcare providers. This study examined the association between Spanish-speaking and non-Spanish-speaking patients' perceptions of PCMH characteristics and satisfaction with the provider. Data were collected using a self-administered survey from two unaffiliated free clinics. Logistic regression modeled the associations between patients' perceptions of PCMH and their satisfaction with their provider, and their desire to see the same provider in the future. The sample consisted of 367 adults; 44 % were Spanish-speaking. Spanish-speaking patients were younger, less educated, and had fewer chronic conditions than non-Spanish-speaking patients. In adjusted analyses for each population, better ratings of the provider's communication skills were associated with increased satisfaction with the provider (Spanish-speaking: OR = 8.33, 95 % CI = 2.19-31.76; non-Spanish-speaking: OR = 31.39, 95 % CI = 6.91-142.62), and willingness to see the provider again (Spanish-speaking: OR = 12.54, 95 % CI = 2.80-56.24; non-Spanish-speaking: OR = 8.77, 95 % CI = 2.40-31.96). Among Spanish-speakers, lower perceived discrimination was associated with 137 % increased odds and higher perceived staff helpfulness had 212 % increased odds of seeing the provider again. Relative to other PCMH components, interpersonal skills were the most important factors in patient satisfaction with free clinics. Increased training for clinicians on cultural competence and clinician-patient communication may lead to improved patient satisfaction for both Spanish and non-Spanish speakers seen at free clinics, particularly clinics in states without Medicaid expansion.
authors.affiliation: Department of Public Health Sciences, The University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
authors.forename: Elena R
authors.initials: ER
authors.lastname: Platonova
authors.affiliation: Department of Public Health Sciences, The University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA. Jwarren1@uncc.edu.
authors.forename: Jan
authors.identifier: http://orcid.org/0000-0002-4855-8260
authors.initials: J
authors.lastname: Warren-Findlow
authors.affiliation: Department of Public Health Sciences, The University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Saunders
authors.affiliation: College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, NC, USA.
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Hutchison
authors.affiliation: School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, USA.
authors.forename: Maren J
authors.initials: MJ
authors.lastname: Coffman
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009657:North Carolina; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D063508:Social Discrimination; D014481:United States
keywords: Discrimination; Free clinics; Hispanics; Patient centered medical home; Patient satisfaction; Uninsured