Medical care services in physician offices and patient satisfaction

• Background and objective: This study examines the effect of medical care services received in a physician office on a patient's satisfaction. Health service satisfaction is important because it can affect an individual's next health service utilization and ultimately impact one's health status in the future. Whereas most previous studies measure quality of health service simply with the time spent with a doctor and/or conduct analysis with small local data with which the outcomes cannot be generalized beyond the patients included in the data, I investigate the effect of detailed service elements and provide results that are nationally representative in the U.S.

• Methods: I use 101,536 adult individuals collected in the 1998 – 2003 Community Tracking Study Household Survey. I use the ordered logit model and estimate the effect of medical services on patient satisfaction, where the four service factors are measured in: thoroughness and carefulness of the examination and treatment, doctor's explanation, doctor's listening (rated in excellent, very good, good, fair, and poor), and time spent in waiting rooms (rated in increments of 0-10, 11-20, 21-30, 31-59, 60 minutes or more).

• Results: Overall, an individual takes thoroughness of examination and treatment as the most important factor and waiting time as the least important factor among the services. The estimation results indicate that poor examination, poor explanation, and poor listening increases one's dissatisfaction up to 2.91 times, 2.14 times, and 2.40 times (p-values < 0.001), respectively. The longer waiting time makes an individual dissatisfied up to 1.40 times (p-value < 0.001). An individual with a high level education, who may be more knowledgeable to judge if the exam is thorough or not, is more likely to be dissatisfied with a lower quality examination. An individual with a lower education cares more if a doctor listens to them well or not. The results indicate that the effect of each service factor is independent (e.g., better explanation does not reduce the dissatisfaction due to longer wait).

• Conclusion: Although the thoroughness of an examination should be assessed based on rigorous medical knowledge rather than a patient's subjective judgment, an individual considers the perceived thoroughness of an examination as the key component in one's satisfaction. Identifying the elements influencing health service satisfaction and understanding their effects would be valuable for physicians and hospital administrators as they consider how to improve health care quality and to provide health care more efficiently.