Chronic illness and patient satisfaction

Abstract

Objective: To examine how the relationship between patient characteristics, patient experience with the health care system, and overall satisfaction with care varies with illness complexity.

Data sources/study setting: Telephone survey in 14 U.S. geographical areas.

Study design: Structural equation modeling was used to examine how relationships among patient characteristics, three constructs representing patient experience with the health care system, and overall satisfaction with care vary across patients by number of chronic illnesses.

Data collection/extraction methods: Random digital dial telephone survey of adults with one or more chronic illnesses.

Principal findings: Patients with more chronic illnesses report higher overall satisfaction. The total effects of better patient-provider interaction and support for patient self-management are associated with higher satisfaction for all levels of chronic illness. The latter effect increases with illness burden. Older, female, or insured patients are more satisfied; highly educated patients are less satisfied.

Conclusions: Providers seeking to improve their patient satisfaction scores could do so by considering patient characteristics when accepting new patients or deciding who to refer to other providers for treatment. However, our findings suggest constructive actions that providers can take to improve their patient satisfaction scores without selection on patient characteristics.

Figure 1

Conceptual Framework Note. Latent endogenous characteristics are measured through survey questions detailed in Table 1.

Figure 2

Summary of Latent Variable Interactions Showing Unstandardized Path Coefficients Note. Bolded parameters indicate individual p-value < 0.5. Parameters are statistically significantly different across complexity levels in the direct effects from understanding of condition and treatment options to overall satisfaction and from support for self-management of illness to overall satisfaction.