Measuring consumer satisfaction to improve quality of care.

Patients' satisfaction affects their decisions regarding health care, so most care providers ultimately implement a program to measure satisfaction. Consumers' expectations influence whether, how soon, and how often they seek care, which provider they choose, and how satisfied they are. For consumers to seek care, they must have high expectations about care quality. Consumers' satisfaction is based on their perception of the treatment and not the quality of the treatment per se. Since health care quality is difficult for patients to assess, providers can present tangible evidence, such as facility design, that patients can use as surrogate measures of care quality. Providers deliver care at several levels, ranging from below standard to ideal. Satisfaction after treatment depends on what level the patient expected, so this must be measured before treatment. Satisfaction scores may be falsely high, since most patients do not wish to give negative answers, or falsely low, since some patients are dissatisfied with life in general. Thus it is helpful to compare the study's results with those in the literature. To gauge satisfaction, researchers have measured repeat usage; behavioral intentions and preferences; beliefs, attitudes, and expectations; or satisfaction and dissatisfaction directly. Some researchers have used measures of overall satisfaction, but these are inadequate because patients express varying levels of satisfaction with different attributes of care. Therefore a research plan should incorporate overall and individual attribute satisfaction scores plus composite measures created algebraically. Focusing on a specific health care episode helps determine which types of provider behavior are related to the satisfaction stated. Measurements should be made in the office before and directly after treatment to compare satisfaction with expectations.