Attitudes Towards Different Types of Healthcare Providers Among Adults Aged 55 Years and Older, Los Angeles County, 2014

Introduction

The Patient Centered Medical Home Model is a team-based care approach typically led by a physician and supported by a team of providers including nurses,physician assistants,nutritionists, pharmacists, educators,care coordinators, and other physician-extenders. The present study examines the comfort level of older adults in discussing personal health issues or problems with physicians and non-physician providers often encountered in this model of care.

Methods

In June of2014 a clinical services online panel survey developed by the Los Angeles County Department of Public Health was administered to adults in the general population of Los Angeles County.Participants were asked a variety of questions related to health attitudes and behaviors, including how comfortable they felt discussing personalhealth issues with a variety of healthcare providers.Data was weighted by age, location,income,sex,race and other demographic distributions countywide.Descriptive and analytic statistics for those aged 55 years older were generated to better understand their attitudes towards physicians and non-physician providers.

Results

Three hundred-eighteen adults over the age of 55 (30%) completed the panel survey; the total sample was 1,044 with a completion rate of35%.1n this restricted sample of older adults, over half were male (52%),white {53%), and had at least some education beyond high school (73%); 65% reported an annual income$50,000.Reported comfort level in discussing personal health was high for doctors and dentists- 95% and 69%, respectively. For non-physician providers,survey participants reported less comfort in speaking to pharmacists (44% reported "high" comfort level) and nurses {only 19% reported "high" comfort level). A majority ofthe participants reported "low" comfort levels discussing personal health with community lay workers (52%) and physician assistants (90%).

Conclusion

As the Patient Centered Medical Home and other team-based care approaches become more common in the healthcare environment, it is important to understand how patients view physician and non-physician providers.Increased attention and effort should be placed on educating older adults about the strengths of a team comprising a mix of these healthcare providers.Increasing patient trust in team-based care is an essential component to an efficient and effective shift towards this type of practice in the changing U.S.healthcare system.

Implications for Practice or Policy

The present analysis identifies patient-level factors (e.g., attitudes towards different types of healthcare providers) that affect the implementation of team-based care in the current healthcare systems of Los Angeles County and elsewhere in the U.S. By directing increased attention to preparing older adults for this emerging approach,health professionals can better help patients capitalize on the benefits of this care model.