Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Abstract

PURPOSE Patient satisfaction is an important health care outcome. This study compared patients' satisfaction with care received for an urgent health problem from their family physician, at an after-hours clinic in which their physician participated, at a walk-in clinic, at the emergency department, from telephone health advisory services, or from more than 1 of those services. METHODSWe mailed a questionnaire to a random sample of patients from 36 family practices in Thunder Bay, Ontario. We elicited satisfaction with care for the most recent urgent health problem in the past 6 months on a 7-point scale (very dissatisfi ed to very satisfi ed). RESULTSThe response rate was 62.3% (5,884 of 9,397). Of the 5,722 eligible patients 1,342 (23.4%) reported an urgent health problem, and data were available for both services used and satisfaction for 1,227 patients. After adjusting for sociodemographic characteristics and self-reported health status, satisfaction with care received for most recent urgent health problem was signifi cantly higher among patients who visited or spoke to their family physician (mean 6.1; 95% confi dence interval [CI], 5.8-6.4) compared with all other services (all P <.004, adjusted for multiple comparisons), with the exception of patients who used the after-hours clinic affi liated with their physician, whose satisfaction was not significantly different (mean 5.6; 95% CI, 5.2-6.0). CONCLUSIONS Satisfaction was highest for patients receiving care from their own family physician or their physician's after-hours clinic. These results are important for new primary care models that emphasize continuity and after-hours availability of family physicians. 2007;5:419-424. 10.1370/afm.704 INTRODUCTION P atient satisfaction is an important outcome of health care services and can affect compliance with medical advice, service utilization, and the clinician-patient relationship. Ann Fam Med1,2 Patients' choice of site for care for perceived urgent health problems is likely to involve a multitude of factors and may, in turn, infl uence health care system organization and continuity of care. Canada, as have many other countries, has faced a shortage of family physicians for many years. For patients with a family physician, options for addressing acute health problems may include an urgent appointment with their own family physician, an after-hours clinic, a walk-in clinic, a hospital emergency department, or telephone health advisory services. Emergency department costs for minor acute illnesses are much higher than treatment in primary care settings, 3 and there are concerns about lack of continuity and duplication of services in walk-in clinics. 4,5 Patients' use of health services other than their family physician's practice is not entirely explained by the urgency of the Michelle Howard, MSc 420 URGENT HE A LT H C A R E S AT ISFAC T IONproblem or by availability of their family physician. For example, up to 30% of emergency department visits have been characterized as inappropriate or not urg...

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