Analysis of Factors Affecting Patient Satisfaction: Focus on Asthma Patients
Background: Patient satisfaction is regarded as an important indicator in assessing the quality of care. Over the past 20 years, in particular, there has been increasing interest in patients' perceptions about the provision of healthcare. Although asthma is a disease that increases the burden on health expenditure and has high cost requirements, there have been few studies evaluating the views of asthma patients about their treatment. The aims of this study were to identify factors affecting the satisfaction of asthma patients and to contribute to the sparse literature on this topic. Methods: The study sample consisted of 387 asthma patients who were referred to Hacettepe University's Chest Diseases Polyclinic and Allergy Unit in Ankara, Turkey, between August 2000 and March 2001. A questionnaire consisting of 66 questions was developed to explore demographic characteristics (11 questions), quality of life (32 questions), severity of disease (2 questions), and patient satisfaction with the care received (21 questions). The items for the satisfaction part of the questionnaire were selected from three separate questionnaires used in three independent studies, including the Patient Satisfaction Questionnaire. Factor analysis was performed on the satisfaction items, which revealed five dimensions in which the items were grouped: (i) doctor competency; (ii) provision of information; (iii) quality of care; (iv) waiting time; and (v) hospital quality. The general reliability coefficient was 0.87. Regression analyses were carried out to determine how patients' satisfaction with their medical treatment was affected by the following variables: demographic characteristics (age, other diseases, sex, education, duration of treatment), severity of disease, quality of life, whether medical tests were performed, and whether treatment was received from academic physicians (professors and associate professors) or from consultants and assistants. Results: The results of the regression analyses revealed that patients who had undergone medical tests or who had received treatment from academic physicians (rather than from consultants or assistants) had higher satisfaction levels than their counterparts. Furthermore, female patients had higher levels of satisfaction than their male counterparts. In addition, it was found that the five satisfaction dimensions were all significantly correlated with each other and that patients' general satisfaction was also significantly correlated with all five satisfaction dimensions. The percentages of patient satisfaction that were likely to be explained by the variables used in the study were 22.7% for doctor competency, 25.6% for provision of information, 46.2% for quality of care, 13.7% for waiting time, and 9% for hospital quality. Overall, 32.4% of satisfaction was explained by the variables used in the study. Conclusion: The fact that only 32.4% of general patient satisfaction was explained by the variables used in the study indicates that there are still very important gaps in our understanding of factors affecting patient satisfaction. This study found that the levels of patient satisfaction with care were influenced by provider characteristics (academic status) rather than patient characteristics. After controlling for patient characteristics, patients of professor and associate professor physicians were more satisfied than patients of assistant physicians, especially in regard to doctor competency, quality of care, provision of information, waiting time, and overall satisfaction. Medical education should continue to emphasize the importance of these aspects of the physician-patient encounter. A qualitative approach could be used in further research to investigate the variance that cannot be explained by other models.
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