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Eval Health Prof. 2016 Dec;39(4):460-474. Epub 2016 Feb 22.

Patient Perception of Enough Time Spent With Provider Is a Mechanism for Improving Women Veterans' Experiences With VA Outpatient Health Care.

Author information

1
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA mark.trentalange@yale.edu.
2
VA Connecticut Healthcare System, Newington, CT, USA.
3
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
4
VA Connecticut Healthcare System, West Haven, CT, USA.
5
Veterans Health Administration Health Services Research & Development, Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA.
6
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.
7
Office of Performance Measurement, VHA Office of Analytics & Business Intelligence, Department of Veterans Affairs, Providence, RI, USA.
8
Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
9
Department of Veterans Affairs, Pittsburgh, PA, USA.
10
Office of Performance Measurement, VHA Office of Analytics & Business Intelligence, Durham, NC, USA.
11
VA Connecticut HSR&D Pain, Research, Informatics, Multimorbidities, and Education (Prime) Center, West Haven, CT, USA.
12
Women's Health Services, Patient Care Services, VA Central Office, VA Connecticut Healthcare System Yale School of Medicine, West Haven, CT, USA.

Abstract

We postulated that associations between two specific provider characteristics, class (nurse practitioner relative to physician) and primary care providers who are proficient and interested in women's health (designated women's provider relative to nondesignated) and overall satisfaction with provider, were mediated through women veterans' perception of enough time spent with the provider. A national patient experience survey was administered to 7,620 women veterans. Multivariable models of overall patient satisfaction with provider were compared with and without the proposed mediator. A structural equation model (SEM) of the mediation of the two provider characteristics was also evaluated. Without the mediator, associations of provider class and designation with overall patient satisfaction were significant. With the proposed mediator, these associations became nonsignificant. An SEM showed that the majority (>80%) of the positive associations between provider class and designation and the outcome were exerted through patient perception of enough time spent with provider. Higher ratings of overall satisfaction with provider exhibited by nurse practitioners and designated women's health providers were exerted through patient perception of enough time spent with provider. Future research should examine what elements of provider training can be developed to improve provider-patient communication and patient satisfaction with their health care.

KEYWORDS:

experiences with health care; nurse practitioners; primary care; structural equation model; veterans; women

PMID:
26908572
PMCID:
PMC4993685
DOI:
10.1177/0163278716629523
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Financial and Personal Conflicts of Interest: Mark Trentalange None Mark Bielawski None Terrence E. Murphy None Katarzyna Lessard None Cynthia Brandt None Bevanne Bean-Mayberry None Natalya C. Maisel None Steven M. Wright None Heather Allore None Melissa Skanderson None Evelyn Reyes-Harvey None Vera Gaetano None Sally Haskell None Lori A. Bastian None Declaration of Conflicting Interests None of the authors have any conflicts of interest related to the research, authorship, or publication of this article.

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