Patient Satisfaction

Sex and Gender-based Analysis of this topic

Definition

Patient satisfaction is the population aged 15 and over who have received health services in the past year and rated their satisfaction level as either “very satisfied” or “somewhat satisfied” [1]. Health services in this definition include: overall health care services; hospital care; physician care; community-based care; and telephone health line or tele-health services [2]. Patient satisfaction is an important measure of people’s experiences with the health care system. It is also recognized as a measure of effectiveness of provider-patient communication [3] and quality of care. In addition, patient satisfaction is associated with better compliance with medical advice [4]. According to the 2005 National Population Health Survey (NPHS), approximately 85% of Canadians receiving health care in the past year reported that they were satisfied with the services received [2].

There are several domains of patient satisfaction including interpersonal aspects, technical quality, access, and/or physical facilities. Usually satisfaction with interpersonal aspects is highest, while satisfaction with access is lowest; however, this varies by setting and expectations. For example, an Ontario study found that patients were more satisfied with interpersonal aspects in family practices and walk-in clinics compared to emergency departments [5]. In terms of wait times, patients are not dissatisfied with a wait of one month for a specialist appointment. However, access to primary care is expected to be more timely [6]. In addition, patients with chronic diseases are less satisfied with access to physician appointments and tend to have higher expectations for timely access.

 
 
Sex Issues

In 2005, the level of patient satisfaction between men and women was similar with 86% of men compared to 84% of women reporting being very or somewhat satisfied with health care services [2]. Canadian women are more frequent users of the health system than men [7], but tend to rate their satisfaction slightly lower than men’s for most health care services.  For example, 81% of women compared to 83% of men were satisfied with their community based health care; 91% of women compared to 92% of men rated their most recent family physician visit as satisfactory. However, women were more satisfied with tele-health services received than men (85% versus 81%) [8].

 
 
Gender Issues

Research has shown that more women compared to men change doctors due to dissatisfaction [9]. Women and men may have different expectations of the health care system, which may effect their satisfaction with services [10]. For example, studies have shown that women value more time and explanations from their doctors compared to men [11]. Also, women may seek out female physicians expecting a more sensitive and empathetic approach to care [12]. Differences in male/female health care provider and patient communication styles may also have an effect on how patients evaluate health care services [13].

 
 
Diversity

Patient satisfaction varies by age, with satisfaction being highest among people aged 65 and older (90%). Patient satisfaction levels were high among 15-19 year olds (88%) and lowest among 20-34 year olds (81%). The patient satisfaction increased with age in age groups 35 and older [2].

The Maritime provinces and the Yukon had the highest levels of satisfaction, with 89% of respondents in both Nova Scotia and New Brunswick and 87% in the Yukon reporting satisfaction [2]. The Northwest Territories (79%) and Nunavut (78%) reported the lowest satisfaction levels in the country. In British Columbia, 84% of residents interviewed reported being satisfied with health care services received. The lower health care satisfaction in Nunavut can be partly explained by poor satisfaction with the availability of physician services in Nunavut compared to the rest of Canada. In Nunavut, most of the primary care is provided by community health nurses with assistance from physicians, with few communities having a resident doctor [14].

 
 
Critique

Patient satisfaction is one domain that may be useful for evaluating Canadian health care services; however satisfaction is usually reported to be high, with little explained variability. The reasons for patient dissatisfaction are not conveyed in these numbers, which would be important information for improving existing services. The role that gender plays in patient satisfaction and the gender differences in patient satisfaction also needs to be explored further. Other data gaps include patient satisfaction among immigrants, non-English speakers, and Aboriginal people.

 
 
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