Patient Satisfaction, Preventive Services, and Emergency Room Use among African-Americans with Type 2 Diabetes

Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.
Disease Management (Impact Factor: 1.39). 12/2005; 8(6):361-71. DOI: 10.1089/dis.2005.8.361
Source: PubMed


The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of <$7500, and all participants had health insurance. All completed a baseline interview-administered questionnaire. Patient satisfaction was measured using a modified version (nine questions) of the Consumer Assessment of Health Plans Survey (CAHPS) and use of diabetes-related preventive health care and ER were assessed by self-report. We then followed participants for 12 months to determine ER use prospectively. In general, participants gave favorable ratings of their care; over 70% reported that they had no problem getting care, over 60% reported the highest ratings on the communication and courtesy domains, and mean ratings (0-10 scale) for personal doctor and overall health care were high (8.8 and 8.4, respectively). Using poisson regression models adjusted for age, education, and self-reported rating of health, several aspects of patient satisfaction were associated with subsequent ER use. Participants who reported that medical staff were usually helpful or that doctors and nurses usually spent enough time were 0.49 and 0.37 times, respectively, less likely to use the ER (all p < 0.05). However, few aspects of patient satisfaction were associated with better preventive services. These data suggest that greater patient satisfaction was associated with lower ER use in urban African-Americans. Whether measures to improve patient satisfaction would reduce ER use requires further prospective study.

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    • "Patient experience domain Patient behavior (adherence, follow-up, self- management) Clinical processes and structures Effectiveness (outcomes) Efficiency (utilization) Safety Care coordination Flocke et al., 1998 Jaipaul & Rosenthal, 2003 Health promotion Sequist et al., 2008 Little et al., 2001 Trust in provider Safran et al., 1998 Rao et al., 2006 O&apos;Malley et al., 2004 Lee & Lin, 2009 Ratanawongsa, et al., 2013 Getting needed care Schneider et al., 2001 Gary, et al., 2005 Getting care quickly Schneider et al., 2001 Brousseau, et al., 2004 Llanwarne, et al., 2013 Health plan information and customer service Schneider et al., 2001 Courtesy, respect, and/or helpfulness of office staff Schneider et al., 2001 Rao et al., 2006 States (Isaac, Zaslavsky, Cleary, & Landon, 2010), and to process indicators relating to 19 different conditions in the United Kindgom (Llanwarne et al., 2013). Overall ratings and willingness to recommend the hospital were lower in hospitals that consistently performed poorly on cardiac process measures over the course of 3 years (Girotra, Cram, & Popescu, 2012). "
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    ABSTRACT: Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization. Patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
    Full-text · Article · Jul 2014 · Medical Care Research and Review

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    ABSTRACT: Assessment of patient satisfaction is required to help to improve health system performance and promote better governance of the hospital services. Despite resource constraints health personnel in private health care delivery centers are providing satisfactory health services than public hospitals. In the face of ever increasing demand for health care services strength, weakness and future prospects of private health care facilities should be evaluated and appraised. On the other hand health care delivery in public hospitals should be closely monitored for further improvement to meet the demands of people.
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