ASSESSMENT OF MEDICAL-CARE BY ELDERLY PEOPLE - GENERAL SATISFACTION AND PHYSICIAN QUALITY

Objective. To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the eld erly people's satisfaction with medical care. Data Sources/Study Setti ng. Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8 ,859 persons age 65 and over living in the community. Study Design. It ems reflecting general satisfaction with care and views of physician q uality are examined and, based on factor analysis, grouped in dimensio ns of two (global quality, access) and three (technical skills, interp ersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteris tics of elderly people, and to measures of access and utilization, is assessed using logistic regression. Principal Findings. While satisfac tion is high, with over 90 percent surveyed expressing some satisfacti on, there is substantial variation with less likelihood of high satisf action among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of p hysician quality, especially regarding technical skills, appears to pl ay a significant role in satisfaction with global quality of care. Con clusions. Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on ea rlier studies, were, e.g., better health and shorter waiting time, whi le others were not, e.g., increasing age. Elderly people appear to pla ce greater importance on physician technical skills, as opposed to int erpersonal dimensions, in assessing global quality. These findings sug gest the need for a better understanding of how elderly people evaluat e care and what they value in interactions with the healthcare system.