The Impact of Patient Autonomy Among Uninsured Free Clinic Patients

J Patient Exp. 2023 Jun 2:10:23743735231179041. doi: 10.1177/23743735231179041. eCollection 2023.

Abstract

Uninsured primary care patients tend to experience barriers to autonomy in clinical decision-making due to limited choices of healthcare facilities and low health literacy. This study examined whether certain factors, including the component of patient-centeredness, are associated with patient autonomy among these populations and contribute to reducing disparities in healthcare. This was a cross-sectional study using a convenience sample of free clinic patients aged 18 years and older who spoke English and/or Spanish. Multiple regression analyses were performed to understand factors associated with Ideal Patient's Autonomy. Data were collected from September to December 2019. Findings conclude that Spanish-speaking patients at the free clinic have a stronger belief in a paternalist model of the provider-patient relationship (P < .01). Better communication between patients and providers results in higher levels of autonomy (P < .01). Higher levels of educational attainment and better communication partnership were associated with higher levels of a free clinic patient's understanding of treatment risks (P < .01). This research study found that components of patient-centeredness are important considerations for improving patient autonomy among free clinic patients.

Keywords: free clinics; health outcome; patient autonomy; uninsured patients.