Patients' knowledge of health plan coverage and satisfaction with care

To test the hypothesis that patients' satisfaction with their healthcare is related to their knowledge of their managed care plan.

A written survey was sent to beneficiaries of the military health system.

Respondents were active or retired military personnel and their nonmilitary, immediate family members enrolled in either TRICARE Prime, a voluntary, gatekeeper-based managed care program (enrollees), or other military managed care programs (nonenrollees). Responses to 5 questions that measured patients' understanding of their program served as independent variables; satisfaction with care was the dependent variable. Responses were stratified according to whether care was received in a military or a civilian healthcare organization. Analysis of variance (ANOVA) and regression analysis were used to determine the association between the variables.

Enrollees differed from nonenrollees in certain sociodemographic characteristics, with nonenrollees being older (eta 2 = 0.035; P < .01), closer to retirement (eta 2 = 0.051; P < .01), and tending to receive healthcare in military healthcare organizations (HCO) (eta 2 = 0.009; P < .01). After controlling for sociodemographic characteristics, patients' understanding of their coverage served as a poor predictor (military HCO [R2 = 0.003; P < .01]; civilian HCO [R2 = 0.025; P < .01]) of satisfaction with their care.

Patients' understanding of their coverage appears to be a statistically significant, but rather small, contributor to satisfaction with their care. The study suggests that health plan understanding is a poor predictor of patient satisfaction.