Patient Satisfaction and Perspectives of Continuity of Care among Free Clinic Patients in the USA: A Qualitative Study

Abstract

Introduction: Free clinics are important resources for those who do not have access to health care other than the emergency room services in the United States. The purpose of this study was to explore continuity of care and patient satisfaction from the perspectives of free clinic patients. Methods: Five focus groups were conducted with patients at a free clinic in June 2017 (N=25). Thematic analysis was performed to identify themes in issues relating to continuity of care and patient satisfaction. Results: Continuity of care was not always perceived positively. There were potential miscommunications between providers or receptionists and patients. Patients may not be well informed of the available resources at the clinic. Discussion: Since the majority of free clinic providers are volunteers and may not be with a free clinic long-term, continuity of care should not be just seeing the same doctor over time, but also seeing well-coordinated providers. Because free clinics serve a wide variety of underserved populations, cultural competence trainings in medical education may not wholly fit the socioeconomic and/or cultural realities of free clinic patients. More in-person communication would be beneficial to distribute the information about available resources for free clinic patients. Conclusion: Communication among patients and receptionists, providers, and interpreters seemed to be a prevalent recurring topic across groups. The communication of health programs and appointment reminders are the areas to be improved. Trainings in communications with patients or cultural competence in medical education may need to consider a wide variety of patient backgrounds.