[Patient satisfaction with outpatient/short stay operations in a practice clinic]

Abstract

Background: In a pilot scheme for outpatient/short-stay surgery in a practice clinic in Magdeburg, Germany, as well as medical indicators patient satisfaction was evaluated as part of its research programme. Typically, the recovery phase is transferred to the home environment. For this reason the practice clinic has little opportunity to observe the patient's post-operative course. Patient satisfaction, therefore, is a particularly important indicator in evaluating the quality of patient care in outpatient, generally elective, surgery. This study assessed patient satisfaction with the services offered by the practice clinic. The analysis also identified which determinants had significant impact on patient satisfaction in order to obtain information about reasonable measures for improvement.

Methods: A questionnaire developed by Blum to evaluate patient satisfaction with outpatient surgery in a hospital setting was slightly modified. The questionnaire contained 77 items, which included overall satisfaction as well as the following attributes: information, participation in decision-making, care, health care processes and organisation, post-operative recovery and follow-up care at home. All 420 patients treated were surveyed during two data collection periods in autumn 2001 and summer 2002.

Results: Response rate was 55.7% (234/420). Overall satisfaction was very high. Only 3.6% of patients were dissatisfied. Of the individual attributes patients were most satisfied with care, follow-up care at home, and participation in decision-making. 19% of the patients had criticisms relating to "post-operative recovery". Three out of six items could be identified as determinants of overall satisfaction (R(2) = 0.4 in a forward stepwise multiple linear regression analysis): participation in decision-making, follow-up care at home and health care processes and organisation in the practice clinic. Patients expectations and needs explained 79% of variance in satisfaction with participation in decision-making.

Discussion: The very high satisfaction scores, however, include criticism of detail and indicate scope for improvement. Negative reaction to the particularly relevant attribute "participation in decision-making" can markedly impair overall satisfaction. Patients' participation in their care has a special place with regard to patient satisfaction. The practice clinic intends to repeat the study as a part of its quality assurance programme.