Continuity of Care: Perspectives of Uninsured Free Clinic Patients

Abstract

Background:Continuity of care is vital to the success of a health-care system because it improves patient satisfaction and health outcomes, and reduces hospitalizations and emergency room visits.Objective:The purpose of this study was to examine free clinic patients’ perspectives of continuity of care in the United States.Method:A convenience sample of free clinic patients who were the age of 18 or older and spoke English or Spanish participated in a self-administered survey from January to April in 2017 (N = 580).Results:Better instructions from providers were associated with higher levels of continuity of care (P < .01). Higher levels of stress and worse self-rated general health were related to lower levels of continuity of care (P < .05 for stress, P < .01 for general health). Being employed was associated with lower levels of continuity of care (P < .05). Non-US born English speakers and Spanish speakers rated continuity of care higher than US born English speakers (P < .01).Conclusion:Even if a patient is unable to see the same physician over time, quality instructions from a well-coordinated provider team may enhance continuity of care from patient perspectives. The social context of patients such as working poor individuals is very important for providers to understand in order to identify barriers to continuity of care.

Continuity of care in primary healthcare settings among patients with chronic diseases in Saudi Arabia

“…This finding is consistent with findings in Canada 34 and the United States. 35 We also found that research has shown that patients with dyslipidemia, diabetes mellitus, hypertension, and asthma had better CoC scores than those with other chronic diseases. This is consistent with previous studies.…”

“…6,44 Furthermore, they may experience lower care satisfaction and treatment plan adherence. 45 These findings may have implications for healthcare professionals and those who establish performance indicators to improve the CoC of patients with chronic diseases. Patients are often seen in multiple clinics and hospitals and prescriptions and medical records are not always shared among institutions.…”

Discrimination and Medical Mistrust in a Racially and Ethnically Diverse Sample of California Adults

“…It is important for clinicians to understand the social contextual issues, which include lack of awareness, accessibility, and acceptability of telehealth, in order to identify barriers to continuity of care. 91 The conversion to telemedicine demonstrates its utility as an effective tool for social distancing in clinical or other settings. 92 It may further marginalize others, however, who instead require physical distancing with social connectedness.…”

Patient Adherence to Health Care Provider Recommendations and Medication among Free Clinic Patients

“…Continuity of care is an important aspect of health care. A previous study at the free clinic has shown that clear guidelines and instruction from health care providers for a patient's treatment regimen was associated with an improved level of continuity of care (34). Improving continuity of care with patients with chronic conditions may result in higher medication adherence (35).…”