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Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany

Authors: Sibel Vildan Altin, Stephanie Stock

Published in: BMC Primary Care | Issue 1/2015

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Abstract

Background

Although health policy makers call for the transformation of health care organizations to health literacy responsive ones, there is limited evidence on the care experiences of patients with limited health literacy skills (HL) in respect to health care quality. We explored if HL and patient-reported experiences regarding access to care and support in care-coordination in primary care organizations (PCO) have an impact on patients satisfaction with the care received by their personal general practitioner (GP).

Methods

A nationwide representative survey was administered in a random sample of 1125 German adults. Binary logistic regression analyses were performed to determine whether HL and perceived access to and coordination of care were associated with satisfaction with care received in primary care adjusting for demographics and health status.

Results

In the unadjusted as well as adjusted model, better accessibility of the primary care practice (β= 1.858; 2.032 p < 0.001) frequent support in care coordination by the general practitioner (β = 2.680; 2.820 p < 0.001) as well as sufficient HL (β = 0.888; 1.228 p < 0.05) were independent predictors of a higher satisfaction with care received in the general practice.

Conclusion

German adults with sufficient HL and positive experiences regarding care coordination and access to care are more satisfied with care received by their personal general practitioner. This result is from major importance for primary care organizations intending to transform their processes and structures to respond to the health literacy needs of their patients more effectively.
Literature
1.
go back to reference Beal AC. High-quality health care: the essential route to eliminating disparities and achieving health equity. Health Aff (Millwood). 2011;30:1868–71.CrossRef Beal AC. High-quality health care: the essential route to eliminating disparities and achieving health equity. Health Aff (Millwood). 2011;30:1868–71.CrossRef
2.
go back to reference Browne AJ, Varcoe CM, Wong ST, Smye VL, Lavoie J, Littlejohn D, et al. Closing the health equity gap: evidence-based strategies for primary health care organizations. Int J Equity Health. 2012;11:59.CrossRefPubMedPubMedCentral Browne AJ, Varcoe CM, Wong ST, Smye VL, Lavoie J, Littlejohn D, et al. Closing the health equity gap: evidence-based strategies for primary health care organizations. Int J Equity Health. 2012;11:59.CrossRefPubMedPubMedCentral
3.
go back to reference Porter ME, Pabo EA, Lee TH. Redesigning primary care: a strategic vision to improve value by organizing around patients’ needs. Health Aff (Millwood). 2013;32:516–25.CrossRef Porter ME, Pabo EA, Lee TH. Redesigning primary care: a strategic vision to improve value by organizing around patients’ needs. Health Aff (Millwood). 2013;32:516–25.CrossRef
4.
go back to reference Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009;361:109–12.CrossRefPubMed Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009;361:109–12.CrossRefPubMed
5.
go back to reference Paasche-Orlow MK, Schillinger D, Greene SM, Wagner EH. How health care systems can begin to address the challenge of limited literacy. J Gen Intern Med. 2006;21:884–7.CrossRefPubMedPubMedCentral Paasche-Orlow MK, Schillinger D, Greene SM, Wagner EH. How health care systems can begin to address the challenge of limited literacy. J Gen Intern Med. 2006;21:884–7.CrossRefPubMedPubMedCentral
6.
go back to reference Teisberg EO, Wallace S. Creating a high-value delivery system for health care. Semin Thorac Cardiovasc Surg. 2009;21:35–42.CrossRefPubMed Teisberg EO, Wallace S. Creating a high-value delivery system for health care. Semin Thorac Cardiovasc Surg. 2009;21:35–42.CrossRefPubMed
8.
go back to reference Altin S, Stock S. Health literate health care organizations and their role in future health care. J Nurse Care. 2015;4:1–3. Altin S, Stock S. Health literate health care organizations and their role in future health care. J Nurse Care. 2015;4:1–3.
9.
go back to reference ODPHP. America’s health literacy: Why we need accessible health information. U.S. Department of Health and Human Services; 2008. ODPHP. America’s health literacy: Why we need accessible health information. U.S. Department of Health and Human Services; 2008.
11.
go back to reference Kolpatzik K. [Gaps in health knowledge.] Lücken beim Gesundheitswissen. Gesundheit und Gesellschaft. 2014;7–8:27–30. Kolpatzik K. [Gaps in health knowledge.] Lücken beim Gesundheitswissen. Gesundheit und Gesellschaft. 2014;7–8:27–30.
12.
go back to reference Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann Intern Med. 2011;155:97–107.CrossRefPubMed Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann Intern Med. 2011;155:97–107.CrossRefPubMed
14.
go back to reference Koh HK, Brach C, Harris LM, Parchman ML. A proposed ‘health literate care model’ would constitute a systems approach to improving patients’ engagement in care. Health Aff (Millwood). 2013;32:357–67.CrossRef Koh HK, Brach C, Harris LM, Parchman ML. A proposed ‘health literate care model’ would constitute a systems approach to improving patients’ engagement in care. Health Aff (Millwood). 2013;32:357–67.CrossRef
15.
go back to reference Brach C, Dreyer BP, Schillinger D. Physicians role in creating health literate organizations: A call to action. J Gen Med. 2013;29:273–5. Brach C, Dreyer BP, Schillinger D. Physicians role in creating health literate organizations: A call to action. J Gen Med. 2013;29:273–5.
16.
go back to reference Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Aff (Millwood). 2013;32:250–8.CrossRef Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Aff (Millwood). 2013;32:250–8.CrossRef
17.
go back to reference Koh HK, Berwick DM, Clancy CM, Baur C, Brach C, Harris LM, et al. New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’. Health Aff (Millwood). 2012;31:434–43.CrossRef Koh HK, Berwick DM, Clancy CM, Baur C, Brach C, Harris LM, et al. New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’. Health Aff (Millwood). 2012;31:434–43.CrossRef
20.
go back to reference Raven MC, Gillespie CC, DiBennardo R, Van Busum K, Elbel B. Vulnerable Patients’ Perceptions of Health Care Quality and Quality Data. Med Decis Making. 2012;32:311–26.CrossRefPubMed Raven MC, Gillespie CC, DiBennardo R, Van Busum K, Elbel B. Vulnerable Patients’ Perceptions of Health Care Quality and Quality Data. Med Decis Making. 2012;32:311–26.CrossRefPubMed
21.
go back to reference Schoen C, Davis K, How S, Schoenbaum S. U.S. health system performance: a national scorecard. Health Aff. 2006;25:w457–75.CrossRef Schoen C, Davis K, How S, Schoenbaum S. U.S. health system performance: a national scorecard. Health Aff. 2006;25:w457–75.CrossRef
23.
go back to reference Messina G, Vencia F, Mecheroni S, Dionisi S, Baragatti L, Nante N. Factors Affecting Patient Satisfaction With Emergency Department Care: An Italian Rural Hospital. Global J Health Sci. 2015;7:30–19. Messina G, Vencia F, Mecheroni S, Dionisi S, Baragatti L, Nante N. Factors Affecting Patient Satisfaction With Emergency Department Care: An Italian Rural Hospital. Global J Health Sci. 2015;7:30–19.
24.
go back to reference Wang MC, Mosen D, Shuster E, Bellows J. Association of patient-reported care coordination with patient satisfaction. J Ambul Care Manage. 2015;38:69–76.CrossRefPubMed Wang MC, Mosen D, Shuster E, Bellows J. Association of patient-reported care coordination with patient satisfaction. J Ambul Care Manage. 2015;38:69–76.CrossRefPubMed
25.
go back to reference Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368:201–3.CrossRefPubMed Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368:201–3.CrossRefPubMed
26.
go back to reference Shea JA, Guerra CE, Ravenell KL, McDonald VJ, Henry CA, Asch DA. Health literacy weakly but consistently predicts primary care patient dissatisfaction. Int J Qual Health Care. 2007;19:45–9.CrossRefPubMed Shea JA, Guerra CE, Ravenell KL, McDonald VJ, Henry CA, Asch DA. Health literacy weakly but consistently predicts primary care patient dissatisfaction. Int J Qual Health Care. 2007;19:45–9.CrossRefPubMed
27.
go back to reference Adams RJ, Stocks NP, Wilson DH, Hill CL, Garavier S, Kickbusch I, et al. Health Literacy - A new concept for general practice? Australien Family Physician. 2009;38:144–7. Adams RJ, Stocks NP, Wilson DH, Hill CL, Garavier S, Kickbusch I, et al. Health Literacy - A new concept for general practice? Australien Family Physician. 2009;38:144–7.
28.
go back to reference Sturmberg JP. Primary health care organizations - through a conceptual and a political lens. J Eval Clin Pract. 2011;17:525–9.CrossRefPubMed Sturmberg JP. Primary health care organizations - through a conceptual and a political lens. J Eval Clin Pract. 2011;17:525–9.CrossRefPubMed
30.
go back to reference Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed
31.
go back to reference Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, et al. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRefPubMedPubMedCentral Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, et al. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRefPubMedPubMedCentral
32.
go back to reference Sarkar U, Piette JD, Gonzales R, Lessler D, Chew LD, Reilly B, et al. Preferences for self-management support: findings from a survey of diabetes patients in safety-net health systems. Patient Educ Couns. 2008;70:102–10.CrossRefPubMed Sarkar U, Piette JD, Gonzales R, Lessler D, Chew LD, Reilly B, et al. Preferences for self-management support: findings from a survey of diabetes patients in safety-net health systems. Patient Educ Couns. 2008;70:102–10.CrossRefPubMed
33.
go back to reference Wallace LS, Cassada DC, Rogers ES, Freeman MB, Grandas OH, Stevens SL, et al. Can screening items identify surgery patients at risk of limited health literacy? J Surg Res. 2007;140:208–13.CrossRefPubMed Wallace LS, Cassada DC, Rogers ES, Freeman MB, Grandas OH, Stevens SL, et al. Can screening items identify surgery patients at risk of limited health literacy? J Surg Res. 2007;140:208–13.CrossRefPubMed
34.
go back to reference Wallace LS, Rogers ES, Roskos SE, Holiday DB, Weiss BD. Brief report: screening items to identify patients with limited health literacy skills. J Gen Intern Med. 2006;21:874–7.CrossRefPubMedPubMedCentral Wallace LS, Rogers ES, Roskos SE, Holiday DB, Weiss BD. Brief report: screening items to identify patients with limited health literacy skills. J Gen Intern Med. 2006;21:874–7.CrossRefPubMedPubMedCentral
35.
go back to reference Wallston KA, Cawthon C, McNaughton CD, Rothman RL, Osborn CY, Kripalani S. Psychometric properties of the brief health literacy screen in clinical practice. J Gen Intern Med. 2014;29:119–26.CrossRefPubMed Wallston KA, Cawthon C, McNaughton CD, Rothman RL, Osborn CY, Kripalani S. Psychometric properties of the brief health literacy screen in clinical practice. J Gen Intern Med. 2014;29:119–26.CrossRefPubMed
36.
go back to reference Rosenthal GE, Shannon SE. The use of patient perceptions in the evaluation of health-care delivery systems. Med Care. 1997;35:NS58–68.CrossRefPubMed Rosenthal GE, Shannon SE. The use of patient perceptions in the evaluation of health-care delivery systems. Med Care. 1997;35:NS58–68.CrossRefPubMed
37.
38.
go back to reference Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70:351–79.CrossRefPubMed Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70:351–79.CrossRefPubMed
39.
go back to reference Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71:522–54.CrossRef Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Med Care Res Rev. 2014;71:522–54.CrossRef
40.
go back to reference Neuburger J, Hutchings A, Black N, van der Meulen JH. Socioeconomic differences in patient-reported outcomes after a hip or knee replacement in the English National Health Service. J Public Health (Oxf). 2013;35:115–24.CrossRef Neuburger J, Hutchings A, Black N, van der Meulen JH. Socioeconomic differences in patient-reported outcomes after a hip or knee replacement in the English National Health Service. J Public Health (Oxf). 2013;35:115–24.CrossRef
41.
go back to reference Conway PH, Mostashari F, Clancy C. The future of quality measurement for improvement and accountability. JAMA. 2013;309:2215–6.CrossRefPubMed Conway PH, Mostashari F, Clancy C. The future of quality measurement for improvement and accountability. JAMA. 2013;309:2215–6.CrossRefPubMed
42.
go back to reference Jordan S, Hoebel J. [Health literacy of the adult population in Germany. Results of the GEDA study.] Gesundheitskompetenz von Erwachsenen in Deutschland. - Ergebnisse der Studie “Gesundheit in Deutschland aktuell” (GEDA). Bundesgesundheitsbl. 2015;58:942–50.CrossRef Jordan S, Hoebel J. [Health literacy of the adult population in Germany. Results of the GEDA study.] Gesundheitskompetenz von Erwachsenen in Deutschland. - Ergebnisse der Studie “Gesundheit in Deutschland aktuell” (GEDA). Bundesgesundheitsbl. 2015;58:942–50.CrossRef
43.
go back to reference Kamtsiuris P, Lange M, Hoffmann R, Schaffrath Rosario AS, Dahm S, Kuhnert R, et al. [The first wave of the study on the health status of German adults (DEGS1). Sample, response, weighting and representativity.] Die erste Welle der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). - Stichprobendesign, Response, Gewichtung und Repräsentativität. Bundesgesundheitsbl. 2013;56:620–30.CrossRef Kamtsiuris P, Lange M, Hoffmann R, Schaffrath Rosario AS, Dahm S, Kuhnert R, et al. [The first wave of the study on the health status of German adults (DEGS1). Sample, response, weighting and representativity.] Die erste Welle der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). - Stichprobendesign, Response, Gewichtung und Repräsentativität. Bundesgesundheitsbl. 2013;56:620–30.CrossRef
Metadata
Title
Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany
Authors
Sibel Vildan Altin
Stephanie Stock
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0372-0

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