Examining Associations Between Relocation, Continuity of Care, and Patient Satisfaction in Military Spouses

摘要

Introduction: The purpose of this study was to determine how frequent permanent change of station moves and turnover in primary care providers are associated with continuity of care and patient satisfaction in military spouses. These domains have been studied extensively in civilian populations, but this study seeks to begin filling a gap in the literature surrounding military spouses and their experiences with the military health system. Materials and Methods: Spouses were recruited via social media to complete a brief online questionnaire to examine factors related to continuity of care and satisfaction with military health care. Results were analyzed using analysis of variance and. 2 tests, and through logistic regression. Results: Continuity of care scores were significantly lower as the number of moves and providers increased. Patient satisfaction was also significantly associated with continuity. In logistic regression analyses, patient-provider relationship and health status were the only significant predictors across two measures of patient satisfaction. Respondents with higher relationship scores were nearly two times more likely to report being satisfied than those with lower scores. Qualitative results indicated that the majority of dissatisfied spouses were unhappy with their military providers, which supported quantitative findings related to patient-provider relationship. Conclusion: No studies have previously been conducted to determine why military health system beneficiaries are less satisfied with care than their civilian counterparts. Discontinuous care is an ongoing issue for military families, which can impact satisfaction and potentially lead to poorer health outcomes. Although the military culture may not allow for fewer relocations, these results indicate that taking steps to promote enduring, trusting relationships with primary care providers may improve patient satisfaction.