A study of patient satisfaction and adherence to preventive care practice guidelines

Patient satisfaction ratings are being used to judge physicians' quality of care and to determine physician reimbursement. We therefore studied the association between patient satisfaction and the quality of medical care received by patients in physicians' offices. Patient satisfaction was measured in a survey of patients cared for by 48 primary care physicians in a health maintenance organization in Southern California. Evidence that patients were offered or received preventive care services was determined by patient survey and medical record abstraction, respectively. The medical records of 3,249 randomly selected elderly patients (65 to 75 years old) were studied. Of these patients, 2,799 completed a patient satisfaction and preventive care services survey (response rate 86.1%), 2,654 completed a patient satisfaction survey (response rate 81.7%), and 2,258 completed a quality-of-life survey (response rate 69.5%). Patients were generally satisfied with their physicians' care (median satisfaction score 4.2; scale 1 to 5, 5 being most satisfied). Patients who received or were offered mammography, clinical breast examination, influenza vaccine, pneumococcal vaccine, tetanus vaccine, exercise counseling, and smoking cessation counseling were more satisfied with their medical care than those patients who did not (P < 0.001 for all tests). After controlling for the physician who was providing the medical care, there was still a statistically significant relationship between these factors and patient satisfaction. We found a significant association between patient satisfaction and the performance of some but not all preventive care services. However, we cannot be certain whether there is a relationship between patient satisfaction and quality of patient care.