Satisfaction with children's medical care in six different ambulatory settings

This article compares mothers' satisfaction with children's medical care in six widely varying settings: fee-for-service solo and group practices, prepaid group practice, public clinics, hospital outpatient departments, and emergency rooms. Data are from a household survey representing 700 children in Washington, D.C. Satisfaction with the physician's friendliness, competence, and personal care, as well as waiting time, atmosphere, and cost were examined, comparing how satisfaction levels varied in relation to patient attributes and also among medical settings. Findings revealed significant differences across settings, even controlling statistically for multiple patient characteristics. Satisfaction with interpersonal items was highest in fee-for-service settings, especially solo practice, whereas satisfaction with cost was highest in the public clinics, followed by the prepaid group practice. Previously published comparisons of utilization and health outcomes in the same settings revealed entirely different rankings. Together, these findings illustrate the multifaceted and paradoxical nature of health system performance.