Do Primary Care Patient Experiences Vary by Teaching versus Nonteaching Facility?

Article Figures & Data

Table 1. Sample Sociodemographic Characteristics of Participants at Teaching and Nonteaching Sites

Characteristics	Participants With Characteristic
Characteristics	Teaching Site (n = 975)	Nonteaching Site (n = 777)
Age (years)
18–34	282 (29)	109 (14)
35–54	335 (∼34)	242 (31)
55–74	278 (28.5)	353 (∼45)
Missing data^* (n = 153)	80 (∼8.5)	73 (∼10)
Sex
Female	697 (71.5)	481 (62)
Male	201 (20.5)	215 (∼28)
Missing data^{^†} (n = 158)	77 (8)	81 (∼10)
Race
White	86 (∼9)	94 (12)
Black	364 (∼37)	337 (∼43)
Asian	14 (∼1.5)	13 (∼1.5)
Native Hawaiian/Pacific Islander	7 (∼0.5)	2 (0.25)
American Indian/Alaskan Native	5 (5)	3 (∼0.25)
Other	300 (∼31)	161 (∼21)
Multiracial^{^‡}	24 (2.5)	13 (∼1.5)
Missing data^{^§} (n = 353)	175 (∼14)	178 (∼20.5)
Latino	457 (∼49)	262 (∼34)
Language of survey
Spanish	213 (∼22)	19 (∼2.5)
English	762 (∼78)	758 (∼97.5)
Insurance payer
Straight Medicaid	56 (∼5.5)	15 (∼2)
Medicaid managed care	491 (∼50.5)	171 (22)
Medicare	14 (∼1.5)	16 (2)
Medicaid and Medicare	4 (∼0.5)	4 (0.5)
Private	198 (∼20)	426 (∼55)
Self-pay	43 (4.5)	3 (∼0.5)
Other	24 (2.5)	16 (2)
Don't know	13 (∼1.5)	8 (1)
Missing data^{^‖} (n = 250)	132 (∼13.5)	118 (∼15)
Education
Less than high school	228 (∼23)	79 (10)
High school education or more	647 (∼66)	611 (∼79)
Missing data^{^¶} (n = 187)	100 (∼11)	87 (∼11)

Data are n(%).
↵* Total missing data for age range are < 9%.
↵† Total of 9% are missing data for sex.
↵‡ Multiracial refers to participants who chose more than one race as an identifier (excludes the category of “other”).
↵§ Total of 21% missing data for race.
↵‖ Total of 14% missing data for insurance payer.
↵¶ Total of 10.5% missing data for education.

Table 2. Overall Health Status by Teaching or Nonteaching Site

Overall Health Status	Participants at Teaching Sites (n = 975)	Participants at Nonteaching Sites (n = 777)
Excellent	83 (8.5)	64 (∼8.5)
Very good	205 (21)	175 (22.5)
Good	307 (31.5)	277 (∼35.5)
Fair	247 (∼25)	169 (∼22)
Poor	49 (5)	16 (∼2)
Missing data^* (n = 160)	84 (∼9)	76 (∼9.5)
Mean score^{^†}	2.97	2.85

Data are n(%).
↵* Total of 9% are missing data for overall health score.
↵† Scores range from 1 to 5 (excellent = 1; poor = 5), with lower scores being more favorable.

Table 3. Patient-Reported Experiences by Teaching Versus Nonteaching Sites

Experiences by Survey	Adjusted Mean Score (95% CI)^*		Adjusted Mean Difference Between Teaching and Nonteaching Sites (95% CI)	P Value
Experiences by Survey	Teaching Sites	Nonteaching Sites		P Value
CAHPS subscales^{^†}
Access to care (n = 846)	4.35 (3.78–4.92)	5.14 (4.47–5.81)	−0.79 (−1.36 to −0.22)	.01
Provider communication (n = 1356)	5.60 (5.44–5.76)	5.52 (5.17–5.86)	0.08 (−0.08 to 0.24)	.33
Clerk/receptionist courtesy (n = 1364)	5.20 (4.66–5.29)	5.52 (4.94–6.10)	−0.32 (−0.86 to 0.23)	.25
PACIC total score and subscales^{^‡}
Total chronic disease score (n = 848)	4.02 (3.84–4.20)	3.79 (3.24–4.33)	0.23 (0.05–0.41)	.01
Patient activation (n = 850)	4.26 (4.05–4.46)	3.81 (3.19–4.43)	0.45 (0.24–0.65)	<.001
Delivery system (n = 841)	4.39 (4.20–4.59)	4.34 (3.76–4.91)	0.05 (−0.14 to 0.25)	.60
Goal setting (n = 892)	3.85 (3.65–4.05)	3.65 (3.05–4.25)	0.20 (−0.001 to 0.40)	.051
Problem solving (n = 800)	4.36 (4.14–4.58)	4.06 (3.38–4.74)	0.30 (0.08–0.52)	.01
Follow-up/coordination (n = 874)	3.59 (3.39–3.80)	3.36 (2.75–3.97)	0.23 (0.03–0.44)	.03

Bold values indicate statistically significant results.
↵* All values are adjusted for age, sex, education, overall health status, race, ethnicity, survey language, and insurance payer.
↵† Scores range from 1 to 6. Higher scores indicate a more favorable patient experiences.
↵‡ Scores range from 1 to 5. Higher scores indicate a more favorable patient experiences.
CAHPS, Consumer Assessment of Health care Providers and Systems; CI, confidence interval; PACIC, Patient Assessment of Chronic Illness Care.