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Usual Source of Care and the Quality of Medical Care Experiences: A Cross-Sectional Survey of Patients From a Taiwanese Community

Tsai, Jenna EdD*; Shi, Leiyu DrPH, MBA, MPA; Yu, Wei-Lung MHA; Lebrun, Lydie A. MPH

doi: 10.1097/MLR.0b013e3181dbdf76
Original Article

Objective: This study used a recent patient survey to examine the relationship between having a usual source of care (USC) and the quality of ambulatory medical care experiences in Taiwan, where there is universal health insurance coverage.

Research Design, Subjects, and Measures: The study design was a cross-sectional survey of 879 patients in Taichung County, Taiwan. Children and adults visiting hospital-based physicians were included. Quality of care was measured using items from the Primary Care Assessment Tool (PCAT), representing 7 ambulatory medical care domains: first contact (ie, access and utilization), longitudinality (ie, ongoing care), coordination (ie, referrals and information systems), comprehensiveness (ie, services available and provided), family centeredness, community orientation, and cultural competence. USC was defined based on responses to 3 survey items from the PCAT.

Results: Having a USC was significantly associated with higher quality of medical care experiences. Specifically, having a USC was associated with improved accessibility and utilization, ongoing care, coordination of referrals, and healthcare providers' family centeredness and cultural competence. However, having a USC was not strongly related with comprehensiveness of services, coordination of information systems, or healthcare providers' community orientation.

Conclusion: In a region with universal health insurance, patients with a USC reported higher quality of medical care experiences compared with those without a USC. Beyond the provision of health insurance coverage, efforts to improve quality of care should include policies promoting USC.

From the *College of General Education, Hungkuang University, Taichung County, Taiwan; †Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ‡Department of Health-Business Administration, Hungkuang University, Taichung County, Taiwan.

Reprints: Jenna Tsai, EdD, Hungkuang University, No. 34, Chung-Chie Rd., Shalu, Taichung County, Taiwan 43302. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.