Skip to main content
Log in

The Association between Patient-Centered Attributes of Care and Patient Satisfaction

  • Original Research Article
  • Published:
The Patient - Patient-Centered Outcomes Research Aims and scope Submit manuscript

Abstract

Background and objective

Little is known about the attributes of care that most strongly impact satisfaction in real-world settings where patients’ limited medical knowledge may restrict their ability to ascertain the true quality of care. We therefore examined the association between patient-centered attributes of physician care (thoroughness, explanation, and listening), in-office waiting time, and patient satisfaction.

Methods

We used the Community Tracking Study Household Survey, a US nationally representative dataset (n = 71,594). Using logistic regression models, we analyzed the association between patient ratings of care attributes and patient satisfaction for the total sample and by subgroups, according to health status, physician type, and visit type.

Results

Patients’ perception of excellent or very good care attributes was strongly associated with being very satisfied with care received (thoroughness of care, odds ratio [OR] 2.64, 95 % confidence interval [CI] 2.31–3.02; listening, OR 2.04, 95 % CI 1.77–2.36; explanation, OR 1.63, 95 % CI 1.42–1.86), as was a waiting time of ≤10 min (OR 1.50, 95 % CI 1.39–1.63). The effect magnitude of thoroughness on satisfaction is particularly strong relative to high-quality listening and explanation among respondents in poor health, and for whom the most recent office visit was to see a generalist or for curative care.

Conclusions

Thoroughness of care was the strongest determinant of patient satisfaction, followed by physician listening and explanation. Especially with patients’ improved access to current medical information, it is important for physicians to recognize that excellent communication cannot serve as a substitute for high-quality, thorough care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Emanuel E, Emanuel L. Four models of the physician–patient relationship. JAMA. 1992;267(16):2221–6.

    Article  CAS  PubMed  Google Scholar 

  2. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? Soc Sci Med. 1997;44(5):681–92.

    Article  CAS  PubMed  Google Scholar 

  3. Ende J, Kazis L, Ash A, et al. Measuring patients’ desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med. 1989;4:23–30.

    Article  CAS  PubMed  Google Scholar 

  4. Mead N, Bower P. Patient-centeredness: a conceptual framework and review of the empirical literatures. Soc Sci Med. 2000;51:1087–110.

    Article  CAS  PubMed  Google Scholar 

  5. Dy S, Purnell T. Key concepts relevant to quality of complex and shared decision-making in health care: a literature review. Soc Sci Med. 2012;74(4):582–7.

    Article  PubMed  Google Scholar 

  6. Otani K, Kurz R, Harris L. Managing primary care using patient satisfaction measures. J Healthc Manag. 2005;50(5):311–24.

    PubMed  Google Scholar 

  7. Ekdahl A, Andersson L, Friedrichsen M. “They do what they think is the best for me”. Frail elderly patients’ preferences for participation in their care during hospitalization. Patient Educ Couns. 2010;80:233–40.

    Article  PubMed  Google Scholar 

  8. Swenson S, Buell S, Zettler P, et al. Patient-centered communication: do patients really prefer it? J Gen Intern Med. 2004;19:1069–79.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Epstein R, Fiscella K, Lesser C, et al. Why the nation needs a policy push on patient-centered health care. Health Aff (Millwood). 2010;29(8):1489–95.

    Article  Google Scholar 

  10. Institute of Medicine. Crossing the quality chasms: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.

    Google Scholar 

  11. Patient-Centered Outcomes Research Institute. National priorities for research and research agenda. Washington, DC: PCORI Board of Governors; 2012.

    Google Scholar 

  12. Wouda J, Van de Wiel H. Education in patient–physician communication: how to improve effectiveness? Patient Educ Couns. 2013;90:46–53.

    Article  PubMed  Google Scholar 

  13. Levinson W, Lesser C, Epstein R. Developing physician communication skills for patient-centered care. Health Aff (Millwood). 2010;29(7):1310–8.

    Article  Google Scholar 

  14. Epstein R, Franks P, Fiscella K, et al. Measuring patient-centered communication in patient–physician consultations: theoretical and practical issues. Soc Sci Med. 2005;61:1516–28.

    Article  PubMed  Google Scholar 

  15. Rosenberg E, Lussier M, Beaudoin C. Lessons for clinicians from physician–patient communication literature. Arch Fam Med. 1997;6:279–83.

    Article  CAS  PubMed  Google Scholar 

  16. Pompili C, Brunelli A, Rocco G, et al. Patient satisfaction after pulmonary resection for lung cancer: a multicenter comparative analysis. Respiration. 2013;85:106–11.

    Article  PubMed  Google Scholar 

  17. Gronroos C. Quality comes to service. In: The service quality handbook. New York: American Management Association;1991.

  18. Lim P, Tang N, Jackson P. An innovative framework for health care performance measurement. Manag Serv Qual. 1999;9(6):423–33.

    Article  Google Scholar 

  19. Brown J, Boles M, Mullooly J, Levinson W. Effect of clinician communication skills training on patient satisfaction: a randomized, controlled trial. Ann Intern Med. 1999;131:822–9.

    Article  CAS  PubMed  Google Scholar 

  20. Smith R, Lyles J, Mettler J, et al. The effectiveness of intensive training for residents in interviewing: a randomized, controlled study. Ann Intern Med. 1998;128(2):118–26.

    Article  CAS  PubMed  Google Scholar 

  21. Hill C, Joonas K. The impact of unacceptable wait time on health care patients’ attitudes and actions. Health Mark Q. 2005;23(2):69–87.

    Article  PubMed  Google Scholar 

  22. Meterko M, Wright S, Lin H, Lowy E, Cleary P. Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine. Health Serv Res. 2010;45(5):1188–204.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Loftus R, Nugent Z, Graff L, et al. Patient satisfaction with the endoscopy experience and willingness to return in a central Canadian health region. Can J Gastroenterol. 2013;27(5):259–66.

    PubMed Central  PubMed  Google Scholar 

  24. Andersen R, Newman J. Societal and individual determinants of medical care utilization in the United States. Milbank Q. 1973;51(1):95–124.

    Article  CAS  Google Scholar 

  25. Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997;45(12):1829–43.

    Article  CAS  PubMed  Google Scholar 

  26. Jackson J, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52:609–20.

    Article  CAS  PubMed  Google Scholar 

  27. Tak H, Ruhnke G, Meltzer D. Association of patient preferences for participation in decision making with length of stay and costs among hospitalized patients. JAMA Intern Med. 2013;173(13):1195–203.

    Article  PubMed  Google Scholar 

  28. Hulka B, Wheat J. Patterns of utilization: the patient perspective. Med Care. 1985;23:438–60.

    Article  CAS  PubMed  Google Scholar 

  29. Hall J, Dornan M. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med. 1990;30(7):811–8.

    Article  CAS  PubMed  Google Scholar 

  30. Taylor J. Technology and planned organizational change. Ann Arbor: Institute for Social Research, University of Michigan; 1971.

    Google Scholar 

  31. Center for Studying Health System Change. Community tracking study household survey, 1998–1999, 2000–2001, and 2003: (United States) (computer file). ICPSR version. Washington, DC: Center for Studying Health System Change (producer), 2002, 2003, and 2006. Ann Arbor, MI: Inter-University Consortium for Political and Social Research (distributor), 2002, 2003, and 2007.

  32. Aickin M, Gensler H. Adjusting for multiple testing when reporting research results: the Bonferroni vs Holm methods. Am J Public Health. 1996;86:726–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Hosmer D, Lemeshow S, Sturdivant R. Applied logistic regression. Hoboken: Wiley; 2013.

    Book  Google Scholar 

  34. Hendrickx J, Pelzer B, Te Grotenhuis M, et al. Collinearity involving ordered and unordered categorical variables. http://fmwww.bc.edu/RePEc/bocode/p/perturb.html. Accessed 30 Jun 2014.

  35. Greeven A, Van Balkom A, Visser S, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatr. 2007;164(1):91–9.

    Article  PubMed  Google Scholar 

  36. Olatunji B, Etzel E, Tomarken A, et al. The effects of safety behaviors on health anxiety: an experimental investigation. Behav Res Ther. 2011;49:719–28.

    Article  PubMed  Google Scholar 

  37. Oliver R. Satisfaction: a behavioral perspective on the consumer. New York: McGraw-Hill; 1997.

    Google Scholar 

  38. Woodside A, Frey L, Daly R. Linking service quality, customer satisfaction, and behavioral intention. J Health Care Mark. 1989;9(4):5–17.

    CAS  PubMed  Google Scholar 

  39. Taylor S, Cronin J. Modeling patient satisfaction and service quality. J Health Care Mark. 1994;14(1):34–44.

    CAS  PubMed  Google Scholar 

  40. Kaiser K, Rauscher G, Jacobs E, et al. The import of trust in regular providers to trust in cancer physicians among white, African American, and Hispanic breast cancer patients. J Gen Intern Med. 2010;26(1):51–7.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Kraetschmer N, Sharpe N, Urowitz S, et al. How does trust affect patient preferences for participation in decision-making? Health Expect. 2004;7(4):317–26.

    Article  PubMed  Google Scholar 

  42. McGlone T, Butler E, McGlone V. Factors influencing consumers’ selection of a primary care physician. Health Mark Q. 2002;19(3):21–37.

    Article  PubMed  Google Scholar 

  43. Ferris L, Williams J, Llewellynthomas H, et al. A guide to direct measures of patient satisfaction in clinical practice. Can Med Assoc J. 1992;146(10):1727–31.

    Google Scholar 

  44. Tai-Seale M. Voting with their feet: patient exit and intergroup differences in propensity for switching usual source of care. J Health Polit Policy Law. 2004;29(3):491–514.

    Article  PubMed  Google Scholar 

  45. Shih YT, Tai-Seale M. Physicians’ perception of demand-induced supply in the information age: a latent class model analysis. Health Econ. 2012;21:252–69.

    Article  PubMed  Google Scholar 

  46. Stone A, Shiffman S, Atienza A, et al. The science of real-time data capture: self-reports in health research. Oxford: Oxford University Press; 2007.

    Google Scholar 

  47. Shiffman S, Stone A, Hufford R. Ecological momentary assessment. Ann Rev Clin Psychol. 2008;4:1–32.

    Article  Google Scholar 

  48. Wyrwich K, Metz S, Kroenke K, et al. Measuring patient and clinician perspectives to evaluate change in health-related quality of life among patients with chronic obstructive pulmonary disease. J Gen Intern Med. 2007;22(2):161–70.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Mechanic D, Bilder S. Treatment of people with mental illness: a decade-long perspective. Health Aff (Millwood). 2004;23(4):84–95.

    Article  Google Scholar 

  50. Cleary P, Edgman-Levitan S. Health care quality: incorporating consumer perspectives. JAMA. 1997;278(19):1608–12.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Tak had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs. Tak, Ruhnke, and Shih have all made significant contributions in developing the hypotheses, designing and performing the empirical analysis, and writing and revising the manuscript. All the authors have approved the final manuscript and attest to the validity and legitimacy of the data, as well as its interpretation.

Conflict of interest

The authors declare no conflicts of interest that are directly relevant to this manuscript, including financial interests, activities, relationships, and affiliations with organizations or entities.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hyojung Tak.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tak, H., Ruhnke, G.W. & Shih, YC.T. The Association between Patient-Centered Attributes of Care and Patient Satisfaction. Patient 8, 187–197 (2015). https://doi.org/10.1007/s40271-014-0073-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40271-014-0073-0

Keywords

Navigation