Satisfaction and Trust
Participants indicated an increased level of general satisfaction with
care was associated with a higher level of trust when evaluating care
provided by the PCP (r=0.76, p=0.001) or the adult hematologist (r=0.72,
p<0.001) (Figure 1A and 1B). Additionally, there were higher
levels of general satisfaction associated with increased communication
with either adult provider (PCP r=0.78 p<0.001 and
hematologist r=0.7 p< 0.001) as well as improved access to
care (PCP r=0.65 p=0.003 and hematologist r=0.49 p=0.025). When
assessing the relationship between trust and communication, it was noted
that higher scores on the communication scale were associated with
increased trust in the provider for both the PCP (r=0.67 p=0.004) and
hematologist (r=0.84 p<0.001) (Figure 2A and 2B) although no
statistically significant association was noted between trust and access
to care. Participants were noted to have higher levels of trust in the
hematologist when compared to the PCP trending towards statistical
significance, mean trust scores 76.5 vs 64.2, (p=0.058). However, there
was no difference in their sub-scores in general satisfaction,
communication, or access to care when comparing these two groups.
Regarding transition experience, those participants that expressed that
they felt extremely prepared for transition were noted to have higher
levels of general satisfaction (r=0.6 p=0.028) and trust (r=0.51 p=0.05)
with their PCP as well as higher levels of trust in their hematologist
(r=0.49 p=0.035). Participants’ residential location impacted their
perception of care from their hematologist. Those residing in the Metro
and South Bay areas had significantly lower levels of both trust (median
57.96, p=0.004 Metro and median 56.83, p=0.002 South Bay) and general
satisfaction (median 2.5, p=0.016 Metro and median 2, p<0.001
South Bay) when compared to the other areas in LA County.
One third of patients that indicated they are connected to a PCP had
positive comments regarding their providers knowledge of their SCD and
the care they received with that provider. Half of participants that
indicated a connection to an adult hematologist had positive feedback
including sentiments that their hematologist is a dedicated provider,
knowledgeable about SCD, and resourceful in coordinating patients’
medical care. However, about one third of patients were concerned about
their hematologists’ lack of knowledge regarding SCD, lack of trust in
the medical care they received, and felt that the only service provided
was medication refills.