A COMPARATIVE-STUDY OF 7 MEASURES OF PATIENT SATISFACTION

The acceptability of satisfaction as a quality indicator is qualified by several well known measurement problems. This study examines the va riability in satisfaction evaluations related to different measurement methods and the effect of response biases on reported satisfaction. S atisfaction evaluations using seven different, commonly used measures of patient satisfaction were obtained from the same sample of responde nts. The seven measures were: 1) a global measure of satisfaction usin g a visual analogue scale; 2) a multidimensional measure of satisfacti on based on the Patient Satisfaction Questionnaire using an evaluation response format (poor, fair, good, very good, excellent); 3) a two-it em overall evaluation of quality using the evaluation response format; 4) a six-item attitude measure of general satisfaction using a five-p oint Likert agree-disagree response format; 5) a four-item attitude me asure of satisfaction with physician, using the agree-disagree respons e format; 6) a four-item measure of behavioral intention; and 7) willi ngness-to-pay in dollars. The percentage of favorable evaluations of c are ranged from 63% to 82% across six of the seven measures. Willingne ss-to-pay does not appear to be a valid measure of satisfaction. Corre lations were highest between measures with similar response formats. A lthough an oppositional response bias was not found, a very substantia l acquiescent response bias was detected. Acquiescence reduced the int ernal consistency of three multiple-item measures, the general and phy sician attitude and behavioral intention measures, to levels unaccepta ble even for group comparisons. Between highly and nonacquiescent resp ondents, levels of satisfaction were somewhat lower for the multidimen sional measure of satisfaction and significantly lower for the two att itude satisfaction measures. Highly acquiescent respondents were older , less well educated, and in poorer health than nonacquiescent subject s. Results of satisfaction evaluations dependent on the measurement me thod used, and unreliability of measurement may be a significant probl em in satisfaction measurement, especially for the oldest and most ill patients.