Understanding Patient Perceptions Towards Direct Primary Care: A Focus Group Study.

Direct primary care (DPC) is a growing model of care that is suggested as an alternative to traditional fee-for-service healthcare. Patient-reported experiences of DPC can provide unique insight into the impact of joining the model and inform quality improvement. The purpose of this study was to investigate patient perceptions of DPC. Thirty-one participants were initially recruited for the study and completed a survey assessing patient demographics. Of the 31 participants, 10 went on to complete the focus group interviews. Qualitative analysis of focus group transcripts identified common themes and subthemes. Focus group findings were stratified into 4 themes including quality of care, access to care, affordability, physician qualities, and reasons for choosing DPC. The top positive subthemes were good communication, joining DPC due to poor past healthcare experiences, and physician personability. The most common negative subthemes were difficulty referring to specialists outside the practice, poor communication, and poor access to medications. All findings were presented and discussed with the investigated clinic to facilitate improvements in healthcare delivery.

Investigating Social Determinants of Health in an Urban Direct Primary Care Clinic.

Direct primary care (DPC) is an emerging model of care distinguished by lower price points for quality comprehensive services. The affordability of DPC attracts a broad patient population that may encompass a wide range of socioeconomic needs. It is critical to identify social determinants of health (SDH) in DPC practices to design strategies aimed to mitigate social risk factors, especially for vulnerable populations that can only afford DPC. As part of this SDH screening initiative, the purpose of the present descriptive study was to assess the SDH characteristics of patients from an urban DPC clinic. To identify these SDH factors, a cohort of 31 patients from the DPC clinic was asked to complete a questionnaire from the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE). The survey outcomes revealed top socioeconomic needs in the domains of stress (77.4%), insurance (51.6%), social integration and support (38.7%), unmet medicine or healthcare needs (35.5%), and unemployment (32.2%). In adopting a community-based participatory research (CBPR) approach, the research team shared the survey outcomes with the DPC clinic to facilitate improvements in overall patient care and implementation of services aimed to address social risk factors as identified in the study.