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. 1998 Feb;32(6):741–758.

Assessment of medical care by elderly people: general satisfaction and physician quality.

Y Lee, J D Kasper
PMCID: PMC1070231  PMID: 9460484

Abstract

OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction 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 physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system.

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Selected References

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  1. Adler G. S. A profile of the Medicare Current Beneficiary Survey. Health Care Financ Rev. 1994 Summer;15(4):153–163. [PMC free article] [PubMed] [Google Scholar]
  2. Aharony L., Strasser S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev. 1993 Spring;50(1):49–79. doi: 10.1177/002570879305000104. [DOI] [PubMed] [Google Scholar]
  3. Cleary P. D., Edgman-Levitan S., McMullen W., Delbanco T. L. The relationship between reported problems and patient summary evaluations of hospital care. QRB Qual Rev Bull. 1992 Feb;18(2):53–59. doi: 10.1016/s0097-5990(16)30507-3. [DOI] [PubMed] [Google Scholar]
  4. DiMatteo M. R., Hays R. The significance of patients' perceptions of physician conduct: a study of patient satisfaction in a family practice center. J Community Health. 1980 Fall;6(1):18–34. doi: 10.1007/BF01324054. [DOI] [PubMed] [Google Scholar]
  5. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988 Sep 23;260(12):1743–1748. doi: 10.1001/jama.260.12.1743. [DOI] [PubMed] [Google Scholar]
  6. Hall J. A., Dornan M. C. Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. Soc Sci Med. 1988;27(6):637–644. doi: 10.1016/0277-9536(88)90012-3. [DOI] [PubMed] [Google Scholar]
  7. Hall J. A., Milburn M. A., Epstein A. M. A causal model of health status and satisfaction with medical care. Med Care. 1993 Jan;31(1):84–94. doi: 10.1097/00005650-199301000-00007. [DOI] [PubMed] [Google Scholar]
  8. Haug M. Doctor patient relationships and the older patient. J Gerontol. 1979 Nov;34(6):852–860. doi: 10.1093/geronj/34.6.852. [DOI] [PubMed] [Google Scholar]
  9. Kurata J. H., Nogawa A. N., Phillips D. M., Hoffman S., Werblun M. N. Patient and provider satisfaction with medical care. J Fam Pract. 1992 Aug;35(2):176–179. [PubMed] [Google Scholar]
  10. Linn L. S., DiMatteo M. R., Chang B. L., Cope D. W. Consumer values and subsequent satisfaction ratings of physician behavior. Med Care. 1984 Sep;22(9):804–812. doi: 10.1097/00005650-198409000-00004. [DOI] [PubMed] [Google Scholar]
  11. Pascoe G. C. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann. 1983;6(3-4):185–210. doi: 10.1016/0149-7189(83)90002-2. [DOI] [PubMed] [Google Scholar]
  12. Ross C. E., Mirowsky J. Socially-desirable response and acquiescence in a cross-cultural survey of mental health. J Health Soc Behav. 1984 Jun;25(2):189–197. [PubMed] [Google Scholar]
  13. Sherbourne C. D., Hays R. D., Ordway L., DiMatteo M. R., Kravitz R. L. Antecedents of adherence to medical recommendations: results from the Medical Outcomes Study. J Behav Med. 1992 Oct;15(5):447–468. doi: 10.1007/BF00844941. [DOI] [PubMed] [Google Scholar]
  14. Ware J. E., Jr, Davies-Avery A., Stewart A. L. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev. 1978 Jan-Feb;1(1):1, 3-15. [PubMed] [Google Scholar]
  15. Ware J. E., Jr, Davies A. R. Behavioral consequences of consumer dissatisfaction with medical care. Eval Program Plann. 1983;6(3-4):291–297. doi: 10.1016/0149-7189(83)90009-5. [DOI] [PubMed] [Google Scholar]
  16. Ware J. E., Jr, Snyder M. K., Wright W. R., Davies A. R. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983;6(3-4):247–263. doi: 10.1016/0149-7189(83)90005-8. [DOI] [PubMed] [Google Scholar]
  17. Williams B. Patient satisfaction: a valid concept? Soc Sci Med. 1994 Feb;38(4):509–516. doi: 10.1016/0277-9536(94)90247-x. [DOI] [PubMed] [Google Scholar]
  18. Williams S. J., Calnan M. Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings. Soc Sci Med. 1991;33(6):707–716. doi: 10.1016/0277-9536(91)90025-8. [DOI] [PubMed] [Google Scholar]
  19. Zastowny T. R., Roghmann K. J., Hengst A. Satisfaction with medical care: replications and theoretic reevaluation. Med Care. 1983 Mar;21(3):294–322. doi: 10.1097/00005650-198303000-00004. [DOI] [PubMed] [Google Scholar]

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