Do primary care patient experiences vary by teaching versus nonteaching facility?

Area of Science:

• Health Services Research
• Medical Education
• Patient-Centered Care

Background:

• Patient experiences are crucial in patient-centered medical homes.
• Teaching sites face competing demands from primary care and resident education, potentially impacting patient experiences.
• Residency educational commitments may also positively influence patient experiences.

Purpose of the Study:

• To compare patient experiences between academic teaching primary care sites and nonteaching primary care sites.

Main Methods:

• Patients from 6 primary care sites (3 teaching, 3 nonteaching) completed surveys.
• Patient experiences were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS) and the Patient Assessment of Chronic Illness Care (PACIC).
• CAHPS domains included access to care, communication, and staff courtesy; PACIC measured chronic care experiences.

Main Results:

• Teaching sites had significantly lower adjusted mean scores for patient-reported access (4.35 vs. 5.14, P = .01).
• Teaching sites demonstrated significantly higher total mean scores for chronic disease care (4.02 vs. 3.79, P = .01).
• Four of five PACIC subscale scores were superior at teaching sites.

Conclusions:

• Lower access scores at teaching sites may be linked to residency program complexities.
• Higher chronic care scores suggest potential benefits from focused residency training in this area.
• Residencies should sustain chronic disease training efforts while addressing access challenges to improve overall patient experiences.