PMID- 26908572
OWN - NLM
STAT- MEDLINE
DCOM- 20180116
LR  - 20190115
IS  - 1552-3918 (Electronic)
IS  - 0163-2787 (Print)
IS  - 0163-2787 (Linking)
VI  - 39
IP  - 4
DP  - 2016 Dec
TI  - Patient Perception of Enough Time Spent With Provider Is a Mechanism for 
      Improving Women Veterans' Experiences With VA Outpatient Health Care.
PG  - 460-474
AB  - We postulated that associations between two specific provider characteristics, 
      class (nurse practitioner relative to physician) and primary care providers who 
      are proficient and interested in women's health (designated women's provider 
      relative to nondesignated) and overall satisfaction with provider, were mediated 
      through women veterans' perception of enough time spent with the provider. A 
      national patient experience survey was administered to 7,620 women veterans. 
      Multivariable models of overall patient satisfaction with provider were compared 
      with and without the proposed mediator. A structural equation model (SEM) of the 
      mediation of the two provider characteristics was also evaluated. Without the 
      mediator, associations of provider class and designation with overall patient 
      satisfaction were significant. With the proposed mediator, these associations 
      became nonsignificant. An SEM showed that the majority (>80%) of the positive 
      associations between provider class and designation and the outcome were exerted 
      through patient perception of enough time spent with provider. Higher ratings of 
      overall satisfaction with provider exhibited by nurse practitioners and 
      designated women's health providers were exerted through patient perception of 
      enough time spent with provider. Future research should examine what elements of 
      provider training can be developed to improve provider-patient communication and 
      patient satisfaction with their health care.
CI  - (c) The Author(s) 2016.
FAU - Trentalange, Mark
AU  - Trentalange M
AD  - Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA 
      mark.trentalange@yale.edu.
FAU - Bielawski, Mark
AU  - Bielawski M
AD  - VA Connecticut Healthcare System, Newington, CT, USA.
FAU - Murphy, Terrence E
AU  - Murphy TE
AD  - Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
FAU - Lessard, Katarzyna
AU  - Lessard K
AD  - VA Connecticut Healthcare System, Newington, CT, USA.
FAU - Brandt, Cynthia
AU  - Brandt C
AD  - VA Connecticut Healthcare System, West Haven, CT, USA.
FAU - Bean-Mayberry, Bevanne
AU  - Bean-Mayberry B
AD  - Veterans Health Administration Health Services Research & Development, Center for 
      the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los 
      Angeles Healthcare System, Sepulveda, CA, USA.
FAU - Maisel, Natalya C
AU  - Maisel NC
AD  - Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo 
      Park, CA, USA.
FAU - Wright, Steven M
AU  - Wright SM
AD  - Office of Performance Measurement, VHA Office of Analytics & Business 
      Intelligence, Department of Veterans Affairs, Providence, RI, USA.
FAU - Allore, Heather
AU  - Allore H
AD  - Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
AD  - Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
FAU - Skanderson, Melissa
AU  - Skanderson M
AD  - Department of Veterans Affairs, Pittsburgh, PA, USA.
FAU - Reyes-Harvey, Evelyn
AU  - Reyes-Harvey E
AD  - Office of Performance Measurement, VHA Office of Analytics & Business 
      Intelligence, Durham, NC, USA.
FAU - Gaetano, Vera
AU  - Gaetano V
AD  - VA Connecticut HSR&D Pain, Research, Informatics, Multimorbidities, and Education 
      (Prime) Center, West Haven, CT, USA.
FAU - Haskell, Sally
AU  - Haskell S
AD  - Women's Health Services, Patient Care Services, VA Central Office, VA Connecticut 
      Healthcare System Yale School of Medicine, West Haven, CT, USA.
FAU - Bastian, Lori A
AU  - Bastian LA
AD  - VA Connecticut Healthcare System, Newington, CT, USA.
LA  - eng
GR  - I01 HX000915/HX/HSRD VA/United States
GR  - P30 AG021342/AG/NIA NIH HHS/United States
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20160222
PL  - United States
TA  - Eval Health Prof
JT  - Evaluation & the health professions
JID - 7805992
MH  - Adult
MH  - Ambulatory Care/*organization & administration/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Nurse Practitioners/*statistics & numerical data
MH  - *Patient Satisfaction
MH  - Perception
MH  - Physicians, Primary Care/*statistics & numerical data
MH  - Socioeconomic Factors
MH  - Time Factors
MH  - United States
MH  - United States Department of Veterans Affairs
MH  - Veterans
MH  - Women's Health
PMC - PMC4993685
MID - NIHMS777584
OTO - NOTNLM
OT  - experiences with health care
OT  - nurse practitioners
OT  - primary care
OT  - structural equation model
OT  - veterans
OT  - women
COIS- Financial and Personal Conflicts of Interest: Mark Trentalange None Mark 
      Bielawski None Terrence E. Murphy None Katarzyna Lessard None Cynthia Brandt None 
      Bevanne Bean-Mayberry None Natalya C. Maisel None Steven M. Wright None Heather 
      Allore None Melissa Skanderson None Evelyn Reyes-Harvey None Vera Gaetano None 
      Sally Haskell None Lori A. Bastian None Declaration of Conflicting Interests None 
      of the authors have any conflicts of interest related to the research, 
      authorship, or publication of this article.
EDAT- 2016/02/26 06:00
MHDA- 2018/01/18 06:00
PMCR- 2016/12/01
CRDT- 2016/02/25 06:00
PHST- 2016/02/26 06:00 [pubmed]
PHST- 2018/01/18 06:00 [medline]
PHST- 2016/02/25 06:00 [entrez]
PHST- 2016/12/01 00:00 [pmc-release]
AID - 0163278716629523 [pii]
AID - 10.1177/0163278716629523 [doi]
PST - ppublish
SO  - Eval Health Prof. 2016 Dec;39(4):460-474. doi: 10.1177/0163278716629523. Epub 
      2016 Feb 22.