Publication year
2017
Citation Title
Examining associations between relocation, continuity of care, and patient satisfaction in military spouses.
Journal Name
Military Medicine
Journal Volume
182
Issue Number
5/6
Page Numbers
e1657-e1664
DOI
10.7205/MILMED-D-16-00191
Summary
Military families experience permanent change of stations (PCS) frequently, which may influence their opportunities to receive continuous medical care. This study examined the associations between PCS, continuity of care, and patient satisfaction by having 175 female military spouses complete questionnaires regarding their experiences with the military health system. Results suggested that discontinuity of care may be one of the reasons that military spouses were not satisfied with the care they received.
Key Findings
Military spouses who experienced more PCS moves and had more providers were likely to report lower continuity of care scores.
Military spouses who received continuous care were more likely to have higher satisfaction scores than those who received discontinuous care.
Military spouses who reported good patient-provider relationships were more likely to be satisfied with their health care.
Implications for Program Leaders
Develop workshops for military families on how to quickly build relationships with their new health providers after a PCS
Offer support groups for military spouses who just experienced a PCS so that they can share information and receive more social support
Provide outreach services that increase awareness of available support to military families experiencing PCS or deployment
Implications for Policy Makers
Recommend professional development for health providers working with military families on how to build quality relationships with patients and be cultural competent
Encourage the development of telemedicine options for military families who have already established positive relationships with providers but have to move due to a PCS
Continue to support programs that assist military families with challenges associated with PCS and deployment
Methods
Participants were recruited via social media or by word of mouth. To be eligible, they had to currently be or had been a military spouse in the previous five years and received primary care at a military treatment facility within the last five years.
Measures included number of PCS moves, continuity of care (length of time assigned to the current provider), patient-provider relationship, and patient satisfaction.
Data were analyzed to examine the associations between relocation, continuity of care, and patient satisfaction.
Participants
Participants were 175 female military spouses with an average age of 31.8 years (age range = 20-53 years, SD = 7.1).
The majority of participants were White (80%), followed by Latino (10%), Asian American (3%), Black (2%), Native American (1%), and other (4%).
Service members' branches of Services were Army (45%), Air Force (27%), Navy (17%), Marines (10%), and Coast Guard (1%).
Limitations
The sample only included female military spouses, which limits the ability to generalize the results of the study to male spouses.
Only self-report data were used in the study; therefore, the data may be subject to memory bias and may not accurately represent past events (e.g., number of PCS moves, continuity of care).
Patient satisfaction was measured by two general questions without referring to each specific provider; therefore, it was impossible to determine whether the satisfaction level was directly associated with patient-provider relationship.
Avenues for Future Research
Recruit both female and male military spouses so that the results can be applicable to both genders
Use documented data to determine the number of PCS moves and continuity of care so that the results are more accurate
Examine other factors (e.g., culture, pay grade) that may potentially influence military families' satisfaction with the military health system
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
The purpose of this study was to determine how frequent permanent change of station moves and turnover in primary care providers are associated with continuity of care and patient satisfaction in military spouses. These domains have been studied extensively in civilian populations, but this study seeks to begin filling a gap in the literature surrounding military spouses and their experiences with the military health system. Spouses were recruited via social media to complete a brief online questionnaire to examine factors related to continuity of care and satisfaction with military health care. Results were analyzed using analysis of variance and χ2 tests, and through logistic regression. Continuity of care scores were significantly lower as the number of moves and providers increased. Patient satisfaction was also significantly associated with continuity. In logistic regression analyses, patient–provider relationship and health status were the only significant predictors across two measures of patient satisfaction. Respondents with higher relationship scores were nearly two times more likely to report being satisfied than those with lower scores. Qualitative results indicated that the majority of dissatisfied spouses were unhappy with their military providers, which supported quantitative findings related to patient–provider relationship. No studies have previously been conducted to determine why military health system beneficiaries are less satisfied with care than their civilian counterparts. Discontinuous care is an ongoing issue for military families, which can impact satisfaction and potentially lead to poorer health outcomes. Although the military culture may not allow for fewer relocations, these results indicate that taking steps to promote enduring, trusting relationships with primary care providers may improve patient satisfaction.
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