[Patient satisfaction in the ambulatory setting: validation of a scale and identification of associated factors]

Patient satisfaction is increasingly used to evaluate the performance of health services. Validated French-language instruments to measure satisfaction are currently lacking. This study was designed to validate a questionnaire of this kind and to identify factors associated with patient satisfaction.

Mail survey of 1027 patients who consulted at 4 different ambulatory health care settings in Geneva, Switzerland. The participation rate was 81%. The questionnaire measured 7 dimensions of satisfaction using 16 items adapted from other sources.

The questionnaire was easy to respond to (scores were available for 95 to 99% of respondents, depending on the scale). The internal consistency of the scales was satisfactory (Cronbach alpha between 0.65 and 0.82) for 5 of 6 multi-item scales; it was lower for the scale which measures satisfaction with access to care. Factor analysis identified two principal components corresponding roughly to the "process" and to the "organization" of care. Open comments also confirmed the validity of the multi-item scales. Several patient or visit characteristics were independently associated with the level of satisfaction: older patients, those who were born in Switzerland, who had a visit appointment, who consulted a specialist, and those who saw the same physician as at their previous visit were more satisfied than other patients.

The brief satisfaction questionnaire described in this paper is easy to use, and its reliability and validity are good. Its use can be recommended in ambulatory health care settings. Several variables associated with the level of satisfaction were identified; they should be measured in satisfaction surveys to allow correct appraisal of the results.