The relationship of patient satisfaction with care and clinical outcomes.

OBJECTIVES The authors examine the relationship between three dimensions of patient satisfaction (quality of care, hospital care, and physician time) and two ways of looking at outcomes: absolute (status at 6 months after surgery) and relative (difference between baseline and follow-up status). METHODS A total of 2,116 patients undergoing cholecystectomy were interviewed before surgery and again at 6 months. The baseline interview addressed health status (general functioning and specific symptoms) and risk factors. The follow-up interview included health status and a series of satisfaction questions. Outcomes included both overall health status and specific symptoms. Potential confounding factors, in addition to baseline status, such as demographics, casemix, and procedure type, were accounted for in the analysis. RESULTS Each of the outcomes was related significantly to each of the satisfaction scales; however, the relative outcomes were related more strongly to satisfaction than were the absolute versions. Although the regression coefficients were highly significant, none of the outcomes measures accounted for more than 8% of the explained variance in the several satisfaction scores. CONCLUSIONS Although outcomes and satisfaction are related, more goes into satisfaction than just outcomes. When determining their satisfaction with the care they have received, patients are more likely to focus on their present state of health than to consider the extent of improvement they have enjoyed.

[1]  J. Ware,et al.  Involving consumers in quality of care assessment. , 1988, Health affairs.

[2]  J E Ware,et al.  Defining and measuring patient satisfaction with medical care. , 1983, Evaluation and program planning.

[3]  R. Wersinger,et al.  Demographic Characteristics and Prior Utilization Experience of HMO Disenrollees Compared With Total Membership , 1982, Medical care.

[4]  Arnold M. Epstein,et al.  Older Patients' Health Status and Satisfaction With Medical Care in an HMO Population , 1990, Medical care.

[5]  M. Osterweis,et al.  Administering Patient Satisfaction Questionnaires at Diverse Ambulatory Care Sites , 1979, The Journal of ambulatory care management.

[6]  S. Greenfield,et al.  Patient Suffering and Patient Satisfaction Among the Chronically Ill , 1982, Medical care.

[7]  A. Donabedian,et al.  Twenty Years of Research on the Quality of Medical Care , 1985, Evaluation & the health professions.

[8]  S J Zyzanski,et al.  Scale for the measurement of attitudes toward physicians and primary medical care. , 1970, Medical care.

[9]  S. Carmel,et al.  Satisfaction with hospitalization: a comparative analysis of three types of services. , 1985, Social science & medicine.

[10]  P. Wilton,et al.  Models of Consumer Satisfaction Formation : An Extension , 1988 .

[11]  B. McNeil,et al.  Patient satisfaction as an indicator of quality care. , 1988, Inquiry : a journal of medical care organization, provision and financing.

[12]  J E Ware,et al.  Methods For Measuring Patient Satisfaction With Specific Medical Encounters , 1988, Medical care.

[13]  W. Tierney,et al.  Measuring patient satisfaction with physicians among older and diseased adults in a primary care municipal outpatient setting. An examination of three instruments. , 1995, Medical care.

[14]  David B. Greenberger,et al.  The Patient Satisfaction Process: Moving Toward a Comprehensive Model , 1993, Medical care review.

[15]  Stephen Strasser,et al.  Patient Satisfaction: What we Know about and What we Still Need to Explore , 1993, Medical care review.

[16]  R. Roberts,et al.  Relationship of service satisfaction to life satisfaction and perceived well-being. , 1983, Evaluation and program planning.

[17]  I. Janis,et al.  Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment , 1977 .

[18]  Arnold M. Epstein,et al.  A Causal Model of Health Status and Satisfaction With Medical Care , 1993, Medical care.

[19]  P. Wilton,et al.  Consumer satisfaction as a process , 1990 .

[20]  J. Sinacore,et al.  A Comparative Study of Seven Measures of Patient Satisfaction , 1995, Medical care.

[21]  B. Hulka,et al.  Satisfaction with medical care in a low income population. , 1971, Journal of chronic diseases.

[22]  R. Kane,et al.  The outcomes of elective laparoscopic and open cholecystectomies. , 1995, Journal of the American College of Surgeons.

[23]  S. Linder-Pelz.  Toward a theory of patient satisfaction. , 1982, Social science & medicine.

[24]  M. Counte.  An examination of the convergent validity of three measures of patient satisfaction in an outpatient treatment center. , 1979, Journal of chronic diseases.

[25]  Gilbert A. Churchill,et al.  An Investigation into the Determinants of Customer Satisfaction , 1982 .

[26]  M. Barry,et al.  Comparing prospective and retrospective measures of treatment outcomes. , 1995, Medical care.

[27]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.

[28]  Judith A. Hall,et al.  Meta-analysis of Correlates of Provider Behavior in Medical Encounters , 1988, Medical care.

[29]  J. Ware,et al.  Patient Satisfaction and Change in Medical Care Provider: A Longitudinal Study , 1983, Medical care.

[30]  Judith A. Hall,et al.  Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. , 1988, Social science & medicine.