Measuring patient satisfaction: a test of construct validity.

OBJECTIVE

To establish the validity of two patient satisfaction questionnaires (surgery satisfaction questionnaire (SSQ) and consultation satisfaction questionnaire (CSQ)) developed for use in general practice.

DESIGN

Prospective study of performance of SSQ and CSQ in patients selected for their predicted levels of satisfaction.

SETTING

Avon Family Health Services Authority (FHSA); general practices in Bristol (practice A) and in Cheltenham (practice B).

PATIENTS

400 patients selected by Avon FHSA who had changed practices but not their home address and whose original practice had not changed its services (group 1); 869 randomly selected patients (221 from practice A, 648 from practice B) (group 2).

MAIN MEASURES

Median difference in satisfaction scores for each questionnaire between groups 1 and 2 and between subgroups of group 2 patients according to assessed level in continuity of care (< 50%, > or = 50%) in the past 12 consultations.

RESULTS

272 (68.0%) patients in group 1 completed the SSQ and CSQ. 711 (81.2%) patients in group 2 (178/221 (80.5%) in practice A, 533/648(82.3%) in practice B) completed the SSQ and 374(88/106(83.0%), 286/335(85.4%)) completed the CSQ. Both questionnaires classified patients in groups 1 and 2 according to the construct of satisfaction; thus the difference in median scores for every component of satisfaction in each questionnaire was significant and occurred in the direction predicted by the construct. Each questionnaire also discriminated between patients grouped according to their assessed level of continuity of care.

CONCLUSION

SSQ and CSQ are valid measures of satisfaction for these types of patients.

IMPLICATIONS

Valid measures of patient satisfaction can be developed; untested instruments should no longer be used.