Patient dissatisfaction as a determinant of voluntary disenrollment in a managed care organization.

An unsatisfactory patient experience during care may lead to a higher probability of disenrollment from a managed care organization (MCO). Compared with previous studies of general dissatisfaction, we examined the effects of specific outpatient visit dissatisfaction on subsequent voluntary disenrollment of 18 809 MCO subscriber units that had at least 1 completed postvisit satisfaction survey in 2000, 2001, or 2002. Subscriber units that reported dissatisfaction with care access, practitioner interaction, or overall visit experience had significantly increased likelihood of voluntary disenrollment from this MCO compared with subscriber units with a satisfactory visit experience.