Primary care clinic size and patient satisfaction in a military setting

Patient satisfaction is a fundamental parameter of quality in health care. Identification of aspects of care that influence patient satisfaction may be used to design changes in health delivery systems, thus improving quality of care. The objective of this study was to examine the relationship between the patient's assessment of quality of health care and the size of primary care clinics (PCCs) (measured as number of monthly patient visits) as well as the physician workload (measured as number of visits per physician per month). This study was a cross-sectional study using PCCs' characteristics and patient satisfaction surveys. One hundred one PCCs were evaluated. There was a negative correlation between all satisfaction indices and the number of primary care physicians in the clinic and the number of monthly visits to the clinic. In contrast, there was no significant correlation between the actual workload per physician. In general linear models, clinic size correlated significantly and negatively with patient satisfaction even after correction for other factors. The study concluded that patient satisfaction in the medical settings of the Israel Defense Forces is adversely affected by large clinic size but is not affected by physician workload.