PATIENT SATISFACTION IN AN AMBULATORY SET TING - VALIDATION OF A SCALE AND IDENTIFICATION OF ASSOCIATED FACTORS

Background: Patient satisfaction is increasingly used to evaluate the performance of health services. Validated French-language instruments to measure satisfaction are currently lacking. This study was designed to validate a questionnaire of this kind and to identify factors asso ciated with patient satisfaction. Methods: Mail survey of 1027 patient s who consulted at 4 different ambulatory health care setting in Genev a, Switzerland. The participation rate was 81%. The questionnaire meas ured 7 dimensions of satisfaction using 16 items adapted from other so urces. Results: The questionnaire was easy to respond to (scores were available for 95 to 99% of respondents, depending on the scale). The i nternal consistency of the scales was satisfactory (Cronbach alpha bet ween 0.65 and 0.82) for 5 of 6 multi-item scales; it was lower for the scale which measures satisfaction with access to care. Factor analysi s identified two principal components corresponding roughly to the ''p rocess'' and to the ''organization'' of care. Open comments also confi rmed the validity of the multi-item scales. Several patient or visit c haracteristics were independently associated with the level of satisfa ction: older patients, those who were born in Switzerland, who had a v isit appointment, who consulted a specialist, and those who saw the sa me physician as at their previous visit were more satisfied than other patients. Conclusions: The brief satisfaction questionnaire described in this paper is easy to use, and its reliability and validity are go od. Its use can be recommended in ambulatory health care settings. Sev eral variables associated with the level of satisfaction were identifi ed; they should be measured in satisfaction surveys to allow correct a ppraisal of the results.