What matters most to patients when they assess quality of their care?

Abstract

Objectives: To report the capabilities of a patient satisfaction questionnaire in capturing factors which are important to patients in their evaluations of the quality of care provided to them.

Design: An experienced research officer introduced the study to all patients with defined tracer conditions in the Saskatoon Health Region from Jan to April of 2009.  Patients who agreed to participate returned their completed questionnaire directly to the research officer or placed them in a special box held by the nursing unit clerk on their unit.

Measures: The instrument contained: 18 items of the General Practice Assessment Questionnaire for physicians and nurses; as well as single items capturing patient observations regarding: attentiveness of nurses; tidiness of facilities; efficiency of tests and treatments; patient comments; and a grading scale assessing overall quality of care. Contextual items covered health status, expenses, insurance and demographics.  A provider care model and a client satisfaction model were constructed and tested.

Results: Almost 96 percent of eligible patients (n=378) completed the questionnaire.  The provider care model explained 84.2 percent of the variation in patients’ assessments of overall quality; and the client satisfaction model explained 67.6 percent of the variation. The quality of nursing and medical care were, the most important factors; however, attentiveness, tidiness, efficiency, and quantified comments each explained small but significant percentages of variance in overall quality.

Conclusions: Patients consider separate dimensions in their assessments of overall quality of care.   While quality of care by professionals trumps other considerations, the passive role for patients is fading.