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Seeing the same doctor: determinants of satisfaction with specialty care for disabled children
Insights
Continuity of physician care significantly enhances patient satisfaction, particularly for families of disabled children. This finding holds true across various specialty clinics, highlighting the importance of a consistent doctor-patient relationship.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Patient Experience
Background:
- Patient satisfaction is a critical metric in healthcare quality assessment.
- Understanding factors influencing satisfaction is vital for improving care delivery, especially for vulnerable populations like disabled children.
- Previous research has explored various aspects of patient satisfaction, but the specific impact of physician continuity in specialized pediatric clinics requires further elucidation.
Purpose of the Study:
- To investigate the effect of physician continuity on patient satisfaction with medical care among families of disabled children.
- To compare satisfaction levels across different specialty clinics and identify key drivers of these differences.
- To determine the independent contribution of continuity of care to patient satisfaction, controlling for other relevant factors.
Main Methods:
- A study involving 370 families of disabled children across four specialty clinics at teaching hospitals.
- Utilized the Patient Satisfaction Questionnaire to assess satisfaction across eight scales.
- Employed multiple regression analysis with predictors including source of care, continuity of care, waiting time, and patient/family characteristics.
Main Results:
- Significant differences in satisfaction scores were observed across clinics, with the cystic fibrosis (CF) clinic showing higher scores.
- Continuity of care was identified as a major factor explaining the association between the source of care and patient satisfaction.
- When physician continuity and waiting time were controlled, satisfaction levels in the CF clinic were comparable to other clinics, indicating continuity's significant role.
Conclusions:
- Continuity of physician care is a substantial contributor to patient satisfaction in pediatric specialty clinics.
- The positive impact of continuity of care extends to both primary and specialized care settings.
- Ensuring consistent physician relationships can mitigate differences in satisfaction potentially arising from clinic-specific factors or waiting times.
Abstract:
The effect of continuity of physician on satisfaction with medical care was examined in a sample of 370 families of disabled children receiving care from four specialty clinics of teaching hospitals. Families of children with myelodysplasia, cystic fibrosis (CF), cerebral palsy and multiple physical handicaps were included. A comparison of scores on the eight scales of the Patient Satisfaction Questionnaire across the four clinics revealed marked and consistent differences: patients of cystic fibrosis clinic scored significantly higher than patients of other clinics on most scales. Multiple regression analysis in which source of care (CF clinic versus other clinics), continuity of care, waiting time and patient and family characteristics (income, race, education, level of disability) were used as predictors indicated that continuity of care accounted for a large part of the association between source of care and satisfaction. Further, when continuity of physician and waiting time in the clinic were held constant, patients of the CF clinic were indistinguishable from patients of other clinics in their satisfaction with doctors and with medical care. Further analysis revealed that continuity of care contributed to patient satisfaction not only in a clinic that constitutes a patient's principal source of care, but also in a clinic in which only specialized care is given, excluding care for intercurrent illnesses or immunizations.