Patient-centered care factors and access to care: a path analysis using the Andersen behavior model.

Area of Science:

• Health Services Research
• Health Policy
• Medical Sociology

Background:

• Access to healthcare is influenced by various factors, including geographic and financial barriers.
• The Andersen behavioral model provides a framework for understanding healthcare utilization.
• Patient-centered care is increasingly recognized as a crucial component of healthcare quality.

Purpose of the Study:

• To examine the relationships between geographic access, financial disadvantage, patient-centered care, and access to care outcomes.
• To investigate how patient-centered care mediates the effects of barriers on healthcare access.

Main Methods:

• Retrospective, cross-sectional study of 15,787 US adults from the Medical Expenditure Panel Survey (2014-2015).
• Structural equation modeling was used to analyze associations between usual source of care, travel time, financial disadvantage, patient-centered care factors, and access to care outcomes.
• Key patient-centered care factors included perceived interaction with health providers, shared decision-making, and perceived value of healthcare.

Main Results:

• Patient-centered care factors were significantly associated with improved perceived access to care (β = 0.03 to 0.56, P = .002).
• Patient-centered care was also linked to reduced unmet needs for health services (β = -0.03 to -0.17, P = .03 to < .001).
• While longer travel times and financial disadvantage negatively impacted access, these effects were mediated by patient-centered care quality.

Conclusions:

• Enhanced patient-centered care is strongly associated with improved patient access to healthcare.
• Focusing on improving the patient experience can be an effective strategy to increase access to quality care.
• These efforts, combined with insurance coverage expansion, can significantly improve healthcare accessibility.