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Primary care satisfaction among adults with physical disabilities: the role of patient-provider communication.

OBJECTIVES
To determine overall satisfaction with primary care among people with cerebral palsy, multiple sclerosis, and spinal cord injury, and to identify potential differences in primary care satisfaction between managed care (MC) and fee-for-service (FFS) enrollees with these physical disabilities.


PARTICIPANTS
The sample consisted of 195 people with cerebral palsy (CP), multiple sclerosis (MS), and spinal cord injury (SCI), between the ages of 18 and 65 who had received primary care services in the six months prior to the survey.


MEASUREMENTS
Satisfaction with various aspects of primary care were assessed using a 10-item self-report measure. Respondents were compared with regard to service satisfaction based on disability and insurance type (MC vs. FFS). Satisfaction items were summed up to produce an unweighted index of overall satisfaction. In the analysis we used non-parametric statistics, such as Kruskal-Wallis One Way ANOVA and Mann-Whitney Rank tests. Post hoc alpha corrections were performed using the Holms Stepdown Procedure.


CONCLUSIONS
The lack of disability-specific knowledge among primary care providers is consistent with findings of other studies. People with physical disabilities in managed care plans are less satisfied with how their providers communicate with them, relative to those in FFS plans. Poor patient-provider communication may place individuals with certain physical disabilities at risk for not receiving appropriate care.