Does patient satisfaction reflect differences in care received after stroke?

Background and Purpose-Despite the volume of research into patient satisfac tion, it is not clear whether satisfaction ratings reflect differences in c are received after stroke or the characteristics of patients. The aim of th is study is to test the hypothesis that patient satisfaction is independent ly related to differences in care received after stroke. Methods-Stroke patients participating in a randomized controlled trial of e arly discharge to community therapy completed a satisfaction questionnaire and physical and psychological outcome measures at 4 and 12 months. Two hun dred seventy-four patients (83%) were followed up at 4 months and 262 patie nts (79%) at 12 months. Use of therapy and community services was quantifie d. Logistic regression was used to investigate associations between satisfa ction, patient characteristics, and service provision. Results-The more therapy, meals on wheels, and home help visits patients re ceived, the more likely they were to be satisfied. Patients in the conventi onal arm of the trial were less likely to express satisfaction than those d ischarged early to community therapy. Women, older people, anxious people, and those more functionally independent were more likely to be satisfied, w hile those with depression, speech and swallowing deficit, motor deficit, a nd poor subjective health were less likely to be satisfied. Conclusions-The finding that satisfaction assessments reflect real differen ces in the provision of care and occur independently of any associations wi th patient characteristics is new. Patient satisfaction should be taken ser iously as an outcome.