Better primary care key to patient satisfaction

A strong primary healthcare system leads to better overall patient satisfaction, according to a recent Philippine study. In turn, this may improve long-term clinical outcomes.

“While patient satisfaction is no conclusive measure of service quality, perceptions of care are almost as important,” researchers said. “From retention to the active involvement of patients in the care they receive, the benefits of examining satisfaction support the goals of a primary care system in improving health outcomes through holistic and comprehensive approaches.”

Two hundred patients (mean age, 34 years; 59 percent female) seeking care at the University of the Philippines Health Service were administered a prevalidated questionnaire at baseline and at study end. The researchers noted greater patient satisfaction in 13 of the 16 questionnaire items over almost a year of follow-up. [Int J Health Plan Manag 2019;doi:10.1002/hpm.2862]

The observed effect was particularly strong in the domain of healthcare availability. For instance, the proportion of patients who were highly satisfied with the efficiency setting appointments for check-ups jumped from 26.5 percent at baseline to 67.0 percent by study end (p<0.001). This corresponded with a significant increase in mean satisfaction scores for this item (3.32 to 3.97; p<0.001).

The same was true for setting appointments for sickness (23.5 percent to 67.5 percent; p<0.001; 3.25 to 3.96; p<0.001) and contacting doctors during off-hours (13.0 percent vs 32.0 percent; p=0.00167; 3.08 to 3.54; p<0.001).

Service efficiency likewise saw large improvements in patient satisfaction. Significantly more patients reported being highly satisfied with waiting times at the office by end-of-study (30.5 percent to 52.5 percent; p<0.001), in conjunction with a jump in mean item scores (3.21 to 3.74; p<0.001).

The researchers also documented notable and significant improvements in patient satisfaction in the domains of medical care received (46.0 percent to 69.0 percent; p<0.001; 3.63 to 4.05; p<0.001), health advice (40.5 percent vs 61.0 percent; p<0.001; 3.58 to 3.90; p<0.001), and on involving other doctors and caregivers (38.0 percent vs 59.0 percent; p<0.001; 3.57 to 3.95; p<0.001).

Significant improvements were reported for almost all questionnaire subdomains, with the exceptions of physician handling and overall recommendability of the facility.

“Considering available evidence, this study concludes that patient satisfaction holds great potential in affecting long-term clinical outcomes depending on patient-health worker dynamics,” the researchers said. “As such, understanding the interpersonal role of health workers in a primary care system becomes essential to its function.”

“Results were subject to several limitations that may account for heightened nonresponse rates and discrepancies in terms of patients' satisfaction toward their environment. To address this, future studies must adapt survey instruments to suit procedural setups unique to each facility and social environment,” they added.