Osteopathic Philosophy and Patient Experience of Care Program | Rebecca Malouin, PhD, MPH, MS, is an associate professor in the Department of Family and Community Medicine and serves as Director of the Global Health Studies Program at Michigan State University. Dr. Malouin is a health services researcher with a specific interest in the experience of care within primary care. She has authored two books, published by the American Academy of Pediatrics, on the measurement of family and patient-centered care within primary care. She has received K01 and R01 funding from the Agency for Healthcare Research and Quality for research on patient-centered primary care and served as an evaluator for several primary care demonstration projects, both federally and privately funded. She has also served on study sections for the Agency for Healthcare Research and Quality, the National Institutes of Health, the Health Resources and Services Administration, the PatientCentered Outcomes Research Institute, the American Association of University Women International Fellowships, and the governments of Israel and New Zealand. Dr. Malouin served as an epidemiologist in the Michigan Department of Community Health and the Maryland Department of Health and Mental Hygiene and as a United States Peace Corps volunteer in Niger. Dr. Malouin received her PhD and MPH in international health from the Johns Hopkins Bloomberg School of Public Health. She also completed an MS in epidemiology from Michigan State University.
Executive Summary: As the United States struggles to control healthcare costs and achieve the quadruple aim, defined as improved patient experience of care, improved physician experience of care, improved quality of care and reduced or controlled costs, identifying successful care models, or components of care models, is of increasing interest to health systems, payers, employers, and increasingly, patients. The research study aims to assess whether the patient experience of care differs between osteopathic and allopathic primary care physicians as reported by patients. The study’s objective is to assess whether differences exist in how patients rate care provided by osteopathic and allopathic physicians. To achieve the objective, investigators conducted a cross-sectional study of patient data collected using the validated Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey. As one of the Centers for Medicare and Medicaid Services (CMS) Multipayer Advanced Primary Care Practice (MAPCP) demonstration sites, the Michigan Primary Care Transformation (MiPCT) is the largest multipayer PCMH initiative in the country with five participating payers. The participating provider base includes 1900 physicians, physician assistants, and nurse practitioners in 350 primary care practices statewide. The MiPCT patient population totals over 1.2M patients, or 12% of the state’s population. Stratified random sampling was utilized with an oversample of patients with high medical risk. Data were analyzed to assess outcomes related to access, communication, coordination, office staff, provider rating, and a summative score of all domains. The main analysis was conducted by employing the general linear model (CSGLM) procedure with post hoc comparisons to assess differences among osteopathic and allopathic physicians after adjusting for race, educational level, payer group, health risk, practice size, hospital ownership, and geography. Consistent with previous studies, patients of osteopathic physicians reported higher communication scores than patients of allopathic physicians in primary care practices. No other significant differences were identified in patient scores. The project is significant because it is the first study to identify differences in the patient-reported experience of care between osteopathic and allopathic physicians using the CAHPS survey, the most widely utilized patient experience of care survey in the United States.