Relationship between the family and community health care model in the Chilean public primary care, and patients’ satisfaction on how they were treated in 2015; A nationwide study

Abstract

Background: Primary care-based healthcare systems are essential for every nation. In 2005, Chile embraced the Family and Community’ Comprehensive Health Care Model (or MAIS) to strengthen the primary care and started to measure its development in 2015 using the “MAIS” assessment tool, created for this purpose. One of the expected outcomes of this model is a higher satisfaction with the interactions with the staff and since 2014, a nationwide survey called TU-APS, measures it for the complete public health care system. The current study aims to establish if a relationship exists between the family-centered health care model in the Chilean public healthcare model, as measured by the MAIS tool, and its user’s satisfaction, measured by the TU-APS. Sample: using 2015 countrywide data, the sample considers 438 large General Urban Centers (GUC), 46 General Rural Centers (GRC) from concentrated areas, and 19 Community Hospitals (CH), obtaining data from 503 centers. Methods: In this secondary data analysis, a cross- sectional non-experimental design was in place, using data already collected by the Ministry of Health. Results: According to the TU-APS national survey results, in average, the users of the primary care in Chile evaluated very positively how they are treated in their encounters with the staff (In as scale from 1 to 7,median of 6.453,95% CI 6.424- 6.481). For the MAIS assessment, in a 1 to 100 scale, a median of 55.57 (95% CI 54.2-57.0) showed a normal distribution. Differences between the type of center and the TU-APS national survey (Kruskal-Wallis test, Chi2=24.747, p<0.001) and the MAIS assessment was found (Chi-square=22.315, p<0.001), but only because of the difference between the CH and the other two groups. When the correlation between the TU-APS survey and the MAIS assessment was tested, a small inverse relation was found (Spearman Rho, r= -0.1119, p = 0.0117), i.e. the highest the MAIS evaluation, the lower the results in the TU-APS survey. Possible causes for these findings are discussed. Conclusions: These results don’t confirm the expected relation between the patients’ satisfaction and the advancement of the MAIS model in the Chilean primary care. This could have implications for policies evaluating primary care patient’s satisfaction