Measuring patient satisfaction for quality improvement

BACKGROUND. Surveys used for health plan quality reporting are generally ad ministered annually to health plan enrollees to assess satisfaction with bo th the health plan and health care services. Therefore, surveys may lack se nsitivity to measure the effects of patient-focused, quality improvement in itiatives that could demonstrate results in a shorter time period. OBJECTIVES. We describe the development and testing of a multidimensional, visit-specific measure of satisfaction with primary care that may be used i n quality improvement. METHODS. Conducted in five adult and pediatric primary care sites serving a commercial, largely managed-care population, the survey includes the Medic al Outcomes Study Visit-Specific Questionnaire, the American Board of Inter nal Medicine Patient Satisfaction Questionnaire, and locally developed item s. We assessed the instrument's reliability, validity, and utility for qual ity improvement. RESULTS. For both adult and pediatric samples, three factors emerged: satis faction with the provider, satisfaction with access, and satisfaction with the office. Satisfaction with the provider and with the office were indepen dently correlated with overall satisfaction in both samples; satisfaction w ith access was significantly correlated with overall satisfaction only for adults. For adults, patients who disenrolled from the health plan were less satisfied with the office compared with patients who remained with the hea lth plan. Finally, for adults, we detected significant differences across p ractice sites in terms of satisfaction with office and access; for children , there were intersite differences in terms of satisfaction with provider, office, and access. CONCLUSIONS. We have support for the reliability and validity of this instr ument that has identified differences in satisfaction between practice site s that may be used for quality improvement.