Factors and Behaviors to Consider when Implementing Patient Centered Medical Home.

摘要

Purpose: Determine which individual characteristics and health behaviors are predictors of patient satisfaction and health status in military beneficiaries, investigate whether healthcare provider support and patience autonomy influence health outcomes, and explore subgroup differences in health outcomes. Design: This was a descriptive, correlational design with a qualitative component. Methods: Participants were recruited from either the study health clinic or adjacent shopping center. Data were collected using a demographic sheet and validated measures for spirituality, participation in religious activities, mistrust, racism/discrimination, access to care, continuity of care, patient-provider communication, interpersonal treatment, communications, patient preference for autonomy, provider autonomy support, patient satisfaction, physical health status, and mental health status. Participants also provided recommendations that would improve their healthcare experiences. Sample: Two-hundred active duty Army Soldiers and family members participated which yielded over 90% power. Analysis: Simple linear, step-wise, and multivariate regression were used to build models to assess relationships between individual characteristics, health behaviors, and health outcomes. ANOVA was used for group comparisons. Participant s open-ended responses were analyzed using content analysis. Findings: In multiple regression analyses, access to care predicted patient satisfaction and mental health status; mistrust predicted patient satisfaction and physical health; spirituality predicted physical health status; and communication behaviors predicted patient satisfaction, physical health status, and mental health status.