What do patients value about primary care that standard satisfaction questionnaires might miss?

Details

The study asked patients to describe important attributes of their primary health care and used their responses to develop a taxonomy for classifying patient satisfaction.

In an open-ended survey design, patients answered questions immediately after a clinic visit. The setting was primary care clinics at an academically affiliated Veterans Affairs Medical Center in New England. Participants were 202 of 204 randomly selected English-speaking patients who agreed and were able to participate.

Using clinimetric methods, researchers obtained responses to three open-ended questions: what patients liked, what they disliked, and what they would like to see changed about their care. These raw descriptions were combined into relevant groups and organized into a patient-satisfaction taxonomy.

The taxonomy had five main axes: physician staff, nonphysician staff, clinic attributes, related services, and the institution. Together, these axes contained 34 items related to patient satisfaction.

The authors described the items as having demonstrable face validity and as likely to be readily understandable to clinicians and policy makers. However, many items—including parking problems—were not included in either of two existing psychometric instruments used to measure patient satisfaction in the same clinics.

The authors concluded that this clinimetric strategy provides a simple, clinically relevant, easily understood assessment of satisfaction with health care services. The assessment can be carried out with three simple questions, and the responses can be catalogued in a suitable taxonomy when desired.