Validating a model of patient satisfaction with emergency care

Study objective: We sought to validate a previously developed model of emer gency department patient satisfaction in a general population using a stand ard mailed format. The study aims to export the findings of a comprehensive ED quality-of-care study to an easily measured patient population. Methods: A double-sided, single-page survey was mailed to all patients disc harged home from 4 teaching hospital EDs during a 1-month period. Determina nts of patient satisfaction were analyzed with a previously developed multi variate, ordinal logistic-regression model. Results: The mail survey response rate was 22.9% (2,373/10,381). The survey validates the importance of previously identified determinants of patient satisfaction, including age, help not received when needed, poor explanatio n of problem, not told about wait time, not told when to resume normal acti vity, poor explanation of test results, and not told when to return to the ED (P < .01). Greater age predicted higher patient satisfaction, whereas al l other variables correlated with lower patient satisfaction. In contrast w ith prior findings, black race was not a significant predictor of satisfact ion in the mail survey population. Low ratings of overall care are strongly correlated with reduced willingness to return (P < .0001). Conclusion: A patient satisfaction model was previously developed from a co mprehensive research survey of ED care. We demonstrate the generalizability of this model to a mail survey population and replicate the finding that s atisfaction strongly predicts willingness to return. The response rate of t his study is typical of commercial patient-satisfaction surveys. The valida ted model suggests that ED patient satisfaction improvement efforts should focus on a limited number of modifiable and easily measured factors.