The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70089

Sarah H. Scholle, DrPH¹, Carol S. Weisman, PhD², Roger T. Anderson, PhD³, Fabian Camacho, MS³, and Fabian Camacho, MS³. (1) University of Pittsburgh, 3811 O'Hara Street, Suite 430, Pittsburgh, PA 15213, 412-624-1703, schollesh@msx.upmc.edu, (2) Department of Health Evaluation Sciences, A210, Penn State College of Medicine, Milton S. Hershey Medical Center, 600 Centerview Drive, Suite 2200, Hershey, PA 17033-0855, (3) Department of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Medical Center Boulevard, Winston-Salem, NC 27157

Objective: Assessing patient satisfaction with health care is becoming an integral component of quality monitoring in health care systems, but existing tools are typically developed to minimize gender differences. This paper reports the psychometric properties of a new survey tool to measure women's satisfaction with their primary care. Design: A multi-site, cross-sectional validation survey of the Primary Care Satisfaction Survey for Women (PCSSW). Item response theory and factor analysis methods were used to identify two scales rating current visit, Communication (8 items) and Administration and Office Procedures (8 items), and another rating overall care during the year (Care Coordination and Comprehensiveness, 10 items). Each PCSSW items is rated on a five-point scale from “1=not at all satisfied” to “5=extremely satisfied.” A score for each scale was calculated by summing the items.. Subjects: Women being seen for a primary care visit were surveyed in four settings in Michigan, North Carolina, and Pennsylvania. 1202 women (69% of those eligible) completed both a pre-visit survey on demographics and expectations for care and a post-visit survey on satisfaction. Most refusals (55%) were due to lack of time to complete the post-visit survey. Measures: Internal consistency reliability is reported, as well as concurrent validity in relation to two generic measures (MOS Visit Satisfaction and CAHPS overall quality rating), discriminant validity in relation to groups expected to have differing satisfaction levels based on previous literature, predictive validity in relation to behavioral intentions, and explanatory power in overall satisfaction ratings. Results: PCSSW scales had high internal consistency reliability (alpha=.88 to .95) and were moderately correlated with generic satisfaction measures (r=.66- .73 with MOS and r=.42-.61 with CAHPS). The scales distinguished among groups based on length of time at the clinic, comprehensiveness of the visit and primary care affiliation. For example, women who said they “got everything they needed today” at their visit had an adjusted mean score of 33.5 on the PCSSW Communication Scale, compared to 24.3 for other women said no to this question (p<.0001). The PCSSW scales also predicted groups differing in their intentions to return or recommend the health care provider. In addition, the Communication and Care Coordination & Comprehensiveness scales add significantly to the variance explained in overall satisfaction ratings beyond the contribution of the generic MOS tool. Conclusions: The PCSSW alone or as adjunct to a generic tool offers new approach for monitoring and improving women’s primary care experiences.

Learning Objectives:

• To appreciate the need for woman-specific measurement of satisfaciton with primary care.
• To understand the methods used to develop a woman-specific tool.
• To understand the psychometric properties of a woman specific tool.
• To identify ways to use a woman-specific tool in research and clinical care.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.