The program evaluation of services in a university primary care clinic: Satisfaction and quality of care

Objectives. The present study constitutes a program evaluation of a university-based pediatric primary care clinic, utilizing the Institute of Medicine (1996) definition of primary care and the American Academy of Pediatrics (1996; 2004) definition of the medical home as guidelines. In addition, because previous research has suggested a relation between children's quality of life and quality of primary care (Seid et al., 2001), the present study examined the relation between children's quality of care and quality of life and determined whether demographic variables moderated that relation. Method. Participants were 107 parents and their children attending primary care appointments at the university-based clinic. Parents completed questionnaires regarding demographics, quality of care, satisfaction with care, negative life events, and children's health-related quality of life. Members of the medical staff were invited to participate, and 16 providers completed questionnaires regarding demographics, job satisfaction, and community resources. Results. In general, parents and providers reported acceptable levels of satisfaction with the quality of care provided in the clinic. Quality of primary care was not significantly related to children's quality of life. However, insurance type affected the relation between quality of care and quality of life. For children with Medicaid, quality of life did not increase with quality of care, but for children with other insurance or no insurance, quality of life did increase with quality of care. Implications. Measurement of quality of care and quality of life in individual clinics has potential to improve care provided. For example, this clinic could improve care and satisfaction ratings by enhancing continuity, coordination, and comprehensiveness of care and by decreasing the time families spend waiting. The present study did not confirm a direct relationship between quality of care and quality of life; however, benefits of quality health care to children's quality of life may be detected as definitions of the two concepts evolve.