What elements of the informational, management, and relational continuity are associated with patient satisfaction with rehabilitation care and global rating change?

Abstract

Objective: To describe the quality of patients' continuity experiences in a population of outpatients receiving postacute rehabilitation care, and to check which elements and types of continuity most strongly determine their satisfaction with care and functional changes.

Design: Cross-sectional self-report survey.

Setting: Three postacute ambulatory centers in metropolitan areas.

Participants: Outpatients (N=218; mean age ± SD, 38.5±11.7y).

Interventions: Not applicable.

Main outcome measures: The questionnaire included experiences regarding aspects of informational (transference of information, accumulated knowledge), management (consistency and flexibility of care), and relational (established relation and consistency of provider) continuity, as well as questions concerning patients' sociodemographic characteristics, satisfaction with care, and global rating change.

Results: Respondents indicated more problems in terms of management and relational continuity than in informational continuity. For all patient groups, experiences regarding elements of management continuity (R(2)=15.3%-22.4%), followed by relational continuity (R(2)=14.3%-25.2%), explained most of the variance of satisfaction. Consistency and flexibility of care, together with an established relation, were the most determining elements of satisfaction. Experiences regarding elements of management continuity explained most of the variance of change (18.5%), and flexibility was the most decisive element.

Conclusions: Patient satisfaction and functional changes are related with experiences in aspects of management continuity, where there is room for improvement. Measures of management continuity may be promising as indicators of continuity, and they should be prioritized.

Keywords: CI; Continuity of patient care; Outpatients; Patient satisfaction; Rehabilitation; confidence interval.