Associations Between Primary Care Providers and Staff-Reported Access Management Challenges and Patient Perceptions...

Area of Science:

• Health Services Research
• Primary Care Medicine
• Patient Access Studies

Background:

• Optimizing patient access to primary care is a significant challenge in healthcare delivery.
• Access management processes within clinics can directly impact patient experiences and outcomes.

Purpose of the Study:

• To assess the relationship between primary care access management challenges and patient-reported access outcomes.
• To identify specific clinic-level challenges that correlate with poorer patient access to care.

Main Methods:

• A cross-sectional study using the National Primary Care Personnel Survey (NPCPS) and the Survey of Healthcare Experiences of Patients-Patient Centered Medical Home (SHEP-PCMH).
• Linked primary care provider (PCP) and staff ratings of access challenges to veteran patient perceptions of care access.
• Employed multi-level, multivariate logistic regressions, controlling for patient, facility, and area characteristics.

Main Results:

• Clinics with higher access management challenges (top 25%) showed significantly lower odds of patients receiving timely urgent appointments (AOR: 0.86) and routine appointments (AOR: 0.74).
• Patients at these clinics also had lower odds of receiving same/next-day answers to telephone questions (AOR: 0.79).
• A strong association was found between increased access management difficulties and diminished patient perceptions of care access.

Conclusions:

• Higher levels of access management challenges in primary care are directly linked to worse patient-reported access outcomes.
• Targeting specific access management issues, such as call center communication, presents an actionable strategy for enhancing the patient experience.