Measuring the patient experience in primary care: Comparing e-mail and waiting room survey delivery in a family health team

Abstract

Objective: To compare the characteristics and responses of patients completing a patient experience survey accessed online after e-mail notification or delivered in the waiting room using tablet computers.

Design: Cross-sectional comparison of 2 methods of delivering a patient experience survey.

Setting: A large family health team in Toronto, Ont.

Participants: Family practice patients aged 18 or older who completed an e-mail survey between January and June 2014 (N = 587) or who completed the survey in the waiting room in July and August 2014 (N = 592).

Main outcome measures: Comparison of respondent demographic characteristics and responses to questions related to access and patient-centredness.

Results: Patients responding to the e-mail survey were more likely to live in higher-income neighbourhoods (P = .0002), be between the ages of 35 and 64 (P = .0147), and be female (P = .0434) compared with those responding to the waiting room survey; there were no significant differences related to self-rated health. The differences in neighbourhood income were noted despite minimal differences between patients with and without e-mail addresses included in their medical records. There were few differences in responses to the survey questions between the 2 survey methods and any differences were explained by the underlying differences in patient demographic characteristics.

Conclusion: Our findings suggest that respondent demographic characteristics might differ depending on the method of survey delivery, and these differences might affect survey responses. Methods of delivering patient experience surveys that require electronic literacy might underrepresent patients living in low-income neighbourhoods. Practices should consider evaluating for nonresponse bias and adjusting for patient demographic characteristics when interpreting survey results. Further research is needed to understand how primary care practices can optimize electronic survey delivery methods to survey a representative sample of patients.

Figure 1.

Participation rates for e-mail and waiting room surveys ^*Includes surveys containing only blank responses. ^†Surveys completed by patients younger than 18 years were excluded.

Figure 2.

Demographic distribution of e-mail survey respondents, waiting room survey respondents, and all patients enrolled in the SMHAFHT: A) Age distribution, B) sex distribution, and C) income quintile. FHT—family health team, SMHAFHT—St Michael’s Hospital Academic FHT.

Figure 3.

Age, gender, and income quintile distribution for all patients enrolled in the SMHAFHT with e-mail addresses available in the medical record compared with those without available e-mail addresses SMHAFHT—St Michael’s Hospital Academic Family Health Team.